Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Best Pract Res Clin Rheumatol. 2010 Jun;24(3):353-61. doi: 10.1016/j.berh.2009.12.014.
Advances in treatment of rheumatoid arthritis have made it possible to profoundly influence signs and symptoms as well as the course of joint destruction in inflammatory arthritis. Earlier and more efficient treatment appears to significantly improve the prognosis of this disease. Despite these advances, cure (the absence of signs and symptoms without further treatment) is still relatively rare, observable in, at most, 20% of the patients. Remission (or a state of very low disease activity), however, has been observed with intense and individually tailored treatment in up to 75% of patients. The use of structured assessments followed by individual modification of the intensity of treatment aiming for remission leads to better clinical responses and radiological outcomes. It remains to be seen whether earlier and more aggressive treatment of patients with not yet 'fully established' rheumatoid arthritis may succeed in preventing at least some of them from progressing to destructive arthritis.
类风湿关节炎治疗的进展使得深刻影响炎症性关节炎的体征和症状以及关节破坏的病程成为可能。更早、更有效的治疗似乎显著改善了这种疾病的预后。尽管取得了这些进展，但治愈（无需进一步治疗即可消除症状和体征）仍然相对罕见，最多只有 20%的患者可达到治愈。然而，通过强化和个体化治疗，高达 75%的患者可达到缓解（或疾病活动度非常低的状态）。采用结构化评估，然后根据每个患者的情况调整治疗强度，以达到缓解的目的，这可带来更好的临床反应和影像学结果。目前尚不清楚，对尚未“完全确诊”的类风湿关节炎患者进行更早、更积极的治疗，是否可能成功地防止其中至少一部分患者进展为破坏性关节炎。
