Emery P, Marzo H, Proudman S
Rheumatology and Rehabilitation Research Unit, University of Leeds, West Yorkshire, UK.
Rheumatology (Oxford). 1999 Nov;38 Suppl 2:27-31.
The traditional pyramidal approach to treatment of rheumatoid arthritis (RA) has the unfortunate effect of treating patients with early RA--those patients with the greatest potential for clinical response--with the least effective agents during the most prolonged and most damaging period of inflammation. Given the wide variety of therapies now available, and the fact that the disease itself can be more destructive than the toxicity of drug therapy, it is important to know the likely outcome for an individual patient so that therapy can be targeted accordingly. The rapid development of new imaging techniques has enabled joint damage to be assessed at a very early stage. The correlation of data obtained from these techniques with clinical data, such as the presence of rheumatoid factor and the shared epitope, may provide a basis on which therapies in the future can be tailored for individual patients.
传统的类风湿关节炎（RA）金字塔式治疗方法存在一个不幸的后果，即在炎症最持久且最具破坏性的时期，使用效果最差的药物来治疗早期RA患者——这些患者具有最大的临床反应潜力。鉴于目前有各种各样的治疗方法，而且疾病本身可能比药物治疗的毒性更具破坏性，了解个体患者可能的预后情况很重要，这样治疗就能有的放矢。新成像技术的迅速发展使得在非常早期阶段就能评估关节损伤。从这些技术获得的数据与临床数据（如类风湿因子的存在和共同表位）之间的相关性，可能为未来针对个体患者量身定制治疗方法提供依据。
