Smolen J S, Aletaha D
Department of Rheumatology, Medical University of Vienna; Second Department of Medicine, Lainz Hospital, Vienna, Austria.
Clin Exp Rheumatol. 2006 Nov-Dec;24(6 Suppl 43):S-7-13.
Remission should be the treatment aim in management of rheumatoid arthritis (RA) today because joint damage may progress in RA patients with low disease activity but presumably does not progress in patients in clinical remission. However, stringent criteria are needed to define remission status, as some criteria in current use allow for considerable residual disease activity. Even using stringent criteria, remission is achievable in a sizable proportion of patients in clinical trials and practice. Defining remission requires an additional consideration: Should a patient who is receiving medication be regarded as in remission if disease is absent, or must the patient be off treatment to be considered to be in remission? A case is made for aiming for a definition of remission that includes patients who continue medication therapy.
如今，缓解应成为类风湿关节炎（RA）治疗的目标，因为疾病活动度低的RA患者关节损伤仍可能进展，但临床缓解的患者关节损伤大概不会进展。然而，需要严格的标准来定义缓解状态，因为目前使用的一些标准仍允许存在相当程度的残余疾病活动度。即便使用严格的标准，在临床试验和实际临床中，仍有相当一部分患者能够实现缓解。定义缓解还需要额外考虑一点：正在接受药物治疗的患者，若没有疾病表现，是否应被视为处于缓解状态，还是必须停药才能被视为处于缓解状态？本文支持将正在接受药物治疗的患者纳入缓解定义范围的观点。
