Pincus T, Ferraccioli G, Sokka T, Larsen A, Rau R, Kushner I, Wolfe F
Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University School of Medicine, 203 Oxford House, Nashville, TN 37232-4500, USA.
Rheumatology (Oxford). 2002 Dec;41(12):1346-56. doi: 10.1093/rheumatology/41.12.1346.
Earlier reports, including a comprehensive 1983 review, had indicated that slowing of radiographic progression was relatively unusual in treatment of rheumatoid arthritis (RA) using traditional disease modifying anti-rheumatic drugs. However, in recent years, slowing of radiographic progression has been documented in a number of clinical trials, as well as long-term observational studies, with use of (in alphabetical order) adalimumab, anakinra, corticosteroids, cyclophosphamide, cyclosporin, etanercept, gold salts, infliximab, leflunomide, methotrexate and sulphasalazine. At this time, disease modification is a realistic goal in the clinical care of patients with RA. Documentation of improved long-term outcomes requires long-term observational data over 5-20 yr to supplement data from randomized controlled clinical trials over 6-24 months.
早期的报告，包括1983年的一份全面综述，表明在使用传统抗风湿药物治疗类风湿关节炎（RA）时，影像学进展减缓相对不常见。然而，近年来，在多项临床试验以及长期观察研究中都记录到了影像学进展减缓的情况，这些研究使用了（按字母顺序排列）阿达木单抗、阿那白滞素、皮质类固醇、环磷酰胺、环孢素、依那西普、金盐、英夫利昔单抗、来氟米特、甲氨蝶呤和柳氮磺胺吡啶。目前，疾病改善是RA患者临床护理中的一个现实目标。记录长期改善的结果需要5至20年的长期观察数据来补充6至24个月的随机对照临床试验数据。
