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[缓解(加强版)项目:临床和影像学缓解:类风湿关节炎管理中的新治疗目标]

[Project REMISSION(PLUS): clinical and radiological remission : new treatment goals in the management of rheumatoid arthritis].

作者信息

Ostendorf B, Scherer A, Kellner H, Backhaus M

机构信息

Klinik für Endokrinologie, Diabetologie und Rheumatologie, Rheumazentrum Rhein-Ruhr, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.

出版信息

Z Rheumatol. 2008 Dec;67(8):707-10, 712-5. doi: 10.1007/s00393-008-0369-3.

Abstract

In a large number of patients with rheumatoid arthritis (RA), chronic inflammatory processes cause joint changes and loss of function even in the early stages of disease. Early, targeted use of disease-modifying antirheumatic drugs [DMARDs and TNF-alpha blockers ("biologicals")] can significantly reduce the risk of aggressive progression and irreversible joint damage. Hence, early identification of disease-specific processes of joint inflammation and erosion - at the onset of disease or later - is of key importance for the patient's prognosis and therapeutic strategy. This can be achieved today with great precision and reliability through the use of modern imaging methods like arthrosonography and magnetic resonance imaging (MRI). The REMISSION(PLUS) initiative aspire to integrate modern imaging technologies as standard methods in the care and management of RA patients. The main areas on which this initiative will be focusing are the conceptualization and implementation of educational programs and training seminars on sonography and MRI, the development and establishment of case report forms for standardized documentation of findings, and the systematic monitoring of patients on treatment, with the aim of producing very precise documentation of structural change processes in RA and also, if possible, to document radiological remission or even progression. The REMISSION(PLUS) project also includes the setting up of specialized centers of excellence, which will network to support the implementation and access to the various imaging procedures at hospitals, rheumatology clinics and rheumatology practices nationwide.

摘要

在大量类风湿关节炎(RA)患者中,即使在疾病早期,慢性炎症过程也会导致关节改变和功能丧失。早期有针对性地使用改善病情抗风湿药[DMARDs和肿瘤坏死因子-α阻滞剂(“生物制剂”)]可显著降低疾病侵袭性进展和不可逆关节损伤的风险。因此,在疾病发作时或之后尽早识别特定于疾病的关节炎症和侵蚀过程,对于患者的预后和治疗策略至关重要。如今,通过使用关节超声检查和磁共振成像(MRI)等现代成像方法,可以非常精确和可靠地实现这一点。REMMISSION(PLUS)倡议致力于将现代成像技术整合为RA患者护理和管理的标准方法。该倡议将重点关注的主要领域包括关于超声检查和MRI的教育项目和培训研讨会的概念化与实施、用于标准化记录检查结果的病例报告表的开发与建立,以及对接受治疗患者的系统监测,目的是非常精确地记录RA中的结构变化过程,并在可能的情况下记录放射学缓解甚至进展情况。REMMISSION(PLUS)项目还包括设立卓越专业中心,这些中心将联网以支持在全国范围内的医院、风湿病诊所和风湿病诊疗机构实施并提供各种成像检查。

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