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[《类风湿关节炎的诊断与治疗实践指南》]

[Practice guideline 'Diagnosis and treatment of rheumatoid arthritis'].

作者信息

Schipper Lydia G, Hoekstra Monique, Vliet Vlieland Thea P M, Jansen Tim L, Lems Willem F, van Riel Piet L C M

机构信息

Universitair Medisch Centrum St Radboud, afdeling Reumatologie, Nijmegen, The Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2009;153:A944.

Abstract

Treatment early in the course of the disease, along with early diagnosis, has a positive influence on clinical outcome in patients with rheumatoid arthritis (RA). Therapeutic strategies, including the use of 'disease-modifying antirheumatic drug' (DMARD) combinations, have proved effective, with relatively few side effects. New insights into the pathophysiology of RA have lead to the development of novel therapeutic agents that have been demonstrated to be highly effective. Patients should be monitored intensively with respect to the effect of therapy on reduction of disease activity, followed by modification of therapeutic strategy in the case of a suboptimal treatment response. Various non-pharmacological interventions, such as exercise therapy and patient education, are available to help patients to cope with the consequences of the disease. Optimizing treatment of RA by means of this approach will help to realize the goal of current therapy: to achieve and sustain remission and, thereby, an optimal functional level.

摘要

在类风湿关节炎(RA)患者中,疾病病程早期的治疗以及早期诊断对临床结局有积极影响。包括使用“改善病情抗风湿药”(DMARD)联合治疗在内的治疗策略已被证明是有效的,且副作用相对较少。对RA病理生理学的新认识促使了新型治疗药物的研发,这些药物已被证明具有高效性。应密切监测患者治疗对降低疾病活动度的效果,若治疗反应欠佳则调整治疗策略。可采用各种非药物干预措施,如运动疗法和患者教育,以帮助患者应对疾病后果。通过这种方法优化RA治疗将有助于实现当前治疗的目标:实现并维持缓解,从而达到最佳功能水平。

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