Department of Internal Medicine, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, 68198-3025, USA.
Curr Opin Rheumatol. 2010 May;22(3):316-20. doi: 10.1097/BOR.0b013e3283383f87.
The present review will focus on the role of conventional disease-modifying antirheumatic drugs (DMARDs) in the current management of rheumatoid arthritis (RA).
Over the past several decades, the treatment of RA has been revolutionized, not only by the development of highly effective biologic agents but also through a better understanding of the critical importance of early DMARD treatment with a goal of remission or low disease activity and of how to effectively and safely use conventional DMARDs, either as monotherapy or in combinations.
Conventional DMARDs have proven efficacy in the management of RA and remain a valid treatment option, either in monotherapy or as a component of combination regimens. Although conventional DMARDs have associated toxicities, these are distinct from those of the biologic DMARDs. In addition, conventional DMARDs are much less expensive than biologic DMARDs, and in many cases can be successful in achieving similar control of disease activity. The goal for all patients should be achieving remission, or at least low disease activity, with the most cost-effective therapy possible.
本综述将重点讨论传统的疾病修饰抗风湿药物（DMARDs）在当前类风湿关节炎（RA）治疗中的作用。
在过去几十年中，RA 的治疗发生了革命性的变化，不仅得益于高效的生物制剂的发展，还得益于对早期 DMARD 治疗的重要性的更好理解，其目标是缓解或低疾病活动度，以及如何有效地、安全地使用传统 DMARDs，无论是单药治疗还是联合治疗。
传统 DMARDs 在 RA 的治疗中已被证明具有疗效，并且仍然是一种有效的治疗选择，无论是单药治疗还是联合治疗方案的一部分。虽然传统 DMARDs 有相关的毒性，但与生物 DMARDs 的毒性不同。此外，传统 DMARDs 比生物 DMARDs 便宜得多，在许多情况下，它们在控制疾病活动方面同样有效。所有患者的目标都应该是用最具成本效益的治疗方法实现缓解，或至少是低疾病活动度。
