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[早期及晚期类风湿关节炎。诊断与最新治疗策略]

[Early and advanced rheumatoid arthritis. Diagnosis and state of the art therapy strategy].

作者信息

Wollenhaupt J, Krüger K

机构信息

Klinik für Rheumatologie und klinische Immunologie und Rheumatologikum, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Deutschland.

出版信息

Z Rheumatol. 2012 Jan;71(1):53-61; quiz 62-3. doi: 10.1007/s00393-011-0932-1.

Abstract

The diagnosis of rheumatoid arthritis (RA) is often based on classification criteria. In 2010 ACR and EULAR presented new classification criteria for RA which allow patients with a high risk for persistent, chronic and erosive arthritis and therefore fulfill the current definition of RA, to be defined. Therapy of RA should be initiated as early as possible. Methotrexate remains the first-line therapy of RA. In patients showing insufficient response of RA, biological agents have been demonstrated to be an effective second-line therapy. It is essential to define and follow an individual treatment target to obtain remission or low disease activity. This target should be reassessed regularly and treatment should be correspondingly adapted to achieve the target.

摘要

类风湿关节炎(RA)的诊断通常基于分类标准。2010年,美国风湿病学会(ACR)和欧洲抗风湿病联盟(EULAR)提出了RA的新分类标准,该标准能够对那些具有持续性、慢性和侵蚀性关节炎高风险且符合当前RA定义的患者进行定义。RA的治疗应尽早开始。甲氨蝶呤仍然是RA的一线治疗药物。对于RA治疗反应不佳的患者,生物制剂已被证明是一种有效的二线治疗药物。明确并遵循个体化治疗目标以实现病情缓解或低疾病活动度至关重要。应定期重新评估该目标,并相应调整治疗方案以实现该目标。

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