Wright V
Department of Rheumatology, University of Leeds, UK.
J Rheumatol Suppl. 1992 Jan;32:95-7.
As effective antiinflammatory agents have been added to our armamentarium, 2 major treatment strategies for the treatment of rheumatoid arthritis have developed. The traditional pyramid strategy is based on initial, conservative measures, followed by more aggressive therapy as the disease progresses. The step-down bridge approach is an alternative, more aggressive strategy that favors earlier use of more potent agents. The longterm effects of disease modifying antirheumatic drugs (DMARD) and combination second line therapy on disease progression remain unclear. Advances in the development of more specific DMARD and in human recombinant proteins offer promising future therapies.
随着有效的抗炎药物被纳入我们的治疗手段，类风湿关节炎的治疗出现了两种主要的治疗策略。传统的金字塔策略基于初始的保守措施，随着疾病进展采用更积极的治疗方法。逐步递减桥梁法是一种替代的、更积极的策略，倾向于更早使用更有效的药物。改善病情抗风湿药（DMARD）和联合二线治疗对疾病进展的长期影响仍不明确。更具特异性的DMARD和重组人蛋白的研发进展为未来治疗带来了希望。
