Hakala Markku, Hannonen Pekka, Helve Tapani, Korpela Markku, Mattila Kimmo, Möttönen Timo, Varis Tiina
Duodecim. 2009;125(19):2131-2.
Anti-citrulline antibodies are highly specific to rheumatoid arthritis (RA) and are thus helpful in differential diagnosis. Early and aggressive disease modifying anti-rheumatic drug (DMARD) therapy is essential for a positive treatment result in cases of RA. Remission during the 1st year of treatment predicts permanent remission, milder joint damage and better functional ability. It is recommended that patients with an unsatisfactory response to DMARDs, including methotrexate and a combination of DMARDs, should be treated primarily with TNF blockers, and non-responders with rituximab or abatacept. RA is an independent risk factor for cardiovascular diseases. The assessment of cardiovascular risk must not be forgotten in daily practice.
抗瓜氨酸抗体对类风湿关节炎（RA）具有高度特异性，因此有助于鉴别诊断。早期积极使用改善病情抗风湿药（DMARD）治疗对于RA患者获得良好的治疗效果至关重要。治疗第1年实现缓解预示着永久缓解、关节损伤较轻且功能能力较好。建议对包括甲氨蝶呤及联合使用DMARDs在内治疗反应不佳的患者，应首先使用肿瘤坏死因子阻滞剂治疗，而对无反应者使用利妥昔单抗或阿巴西普治疗。RA是心血管疾病的独立危险因素。日常实践中切勿忘记对心血管风险进行评估。
