Progression in early rheumatoid arthritis.
Progression in early rheumatoid arthritis.
复制标题
DOI：
10.1016/j.berh.2008.11.006
复制
发表时间：
2009-02-01
期刊：
影响因子：
--
通讯作者：
Combe, Bernard
中科院分区：
文献类型：
--
作者：
Combe, Bernard
类风湿性关节炎（RA）是一种异质性很强的疾病，其预后很难预测。绝大多数患者将出现疾病进展，伴有骨侵蚀和软骨破坏，导致关节破坏、功能障碍和死亡率增加。在过去的几年里，RA的管理，以预防和控制疾病进展已经发生了很大的变化。目前的治疗目标应该是实现临床缓解，以防止结构性损伤和长期残疾。早期使用有效的疾病缓解抗风湿药物（DMARDs）是患者发生持续性和糜烂性关节炎风险的关键。强化治疗，如联合DMARD加类固醇或主要是生物治疗，可以诱导高缓解率和控制放射学进展，并可以提供更好的结果比DMARD单药治疗早期RA，并应考虑在风险患者非常早期。此外，必须密切监测疾病活动和放射学进展，以便在必要时调整DMARD治疗和策略。
Rheumatoid arthritis (RA) is a very heterogeneous disease, the outcome of which is difficult to predict. The vast majority of the patients will have disease progression with bone erosions and cartilage breakdown resulting in joint destruction, functional impairment, and increased mortality. The management of RA to prevent and control disease progression has changed considerably in the past few years. The treatment goal should now be to achieve clinical remission in order to prevent structural damage and long-term disability. A very early use of effective disease-modifying anti-rheumatic drugs (DMARDs) is a key point in patients at risk of developing persistent and erosive arthritis. Intensive treatment such as combination DMARDs plus steroids or mainly biological therapies can induce high rates of remission and control of radiological progression, and can provide better outcomes than DMARD monotherapy in early RA, and should be considered very early in at-risk patients. In addition, close monitoring of disease activity and radiographic progression is mandatory in order to adapt DMARD therapy and strategy if necessary.