Unmet Needs in Rheumatoid Arthritis
Unmet Needs in Rheumatoid Arthritis
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DOI：
10.3899/jrheum.090131
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发表时间：
2009-06-01
影响因子：
3.9
通讯作者：
Bykerk, Vivian
中科院分区：
文献类型：
--
作者：
Bykerk, Vivian
尽管最近在类风湿性关节炎（RA）的治疗方面取得了进展，包括引入生物疗法和使用联合疾病缓解抗风湿药物（DMARD）策略，但缓解率仍然不理想，RA患者仍然缺少大量工作日。需要早期诊断标准，以确保早期开始适当的治疗，以防止关节损伤。还需要更好的预后标记物来识别可能出现不良预后的患者。由于严格的纳入标准和不同的缓解定义，RA临床试验的结果不一定能推广到临床实践中。因此。现有的指导方针可能不能充分反映当前的做法。在缺乏生物标志物来预测疾病进程的情况下，甲氨蝶呤仍然是大多数RA患者最初的标准治疗。预测病程的能力可以允许更合适的靶向治疗和更高的缓解率。（中国风湿病杂志2009；36增刊82:42-46；doi:10.3899/ jrheumat.090131）
Despite recent advances in the treatment of rheumatoid arthritis (RA), including the introduction of biologic therapies and employment of combination disease-modifying antirheumatic drug (DMARD) strategies, remission rates remain suboptimal and patients with RA are still missing a significant number of work days. Early diagnostic criteria are needed to ensure that appropriate treatment is initiated early so as to prevent joint damage. Better prognostic markers are also needed to identify patients with the potential for poor outcomes. in whom more aggressive strategies can be applied at the outset Because of stringent inclusion criteria and heterogeneous definitions of remission, results seen in clinical trials of RA are not necessarily generalizable to results seen in clinical practice. As a result. existing guidelines may not adequately reflect current practice. In the absence of biomarkers to predict the course of disease, methotrexate remains the standard of care initially for most patients with RA. The ability to predict the course of disease Could allow more appropriately targeted therapy and higher rates of remission. (J Rheumatol 2009;36 Suppl 82:42-46; doi:10.3899/jrheum.090131)