Tanaka Yoshiya
The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
Clin Calcium. 2012 Feb;22(2):169-78.
Rheumatoid arthritis (RA) is a representative autoimmune disease characterized by chronic and destructive inflammatory synovitis that causes severe disability and mortality. Since joint destruction occurs from the early disease, its diagnosis and treatment have to be done timely. 2010 RA classification criteria redefine the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease. Thus, a new concept of 'treat-to-target' is emerging in treatments of RA, whereby patients are treated according to prespecified goals, such as remission. Accordingly, the combinational use of methotrexate and biologics targeting TNF and IL-6 has revolutionized the treatment of RA, producing significant improvements in clinical and structural outcomes, and has produced upcoming endpoint for the treatment as the clinical and structural remission.
类风湿关节炎（RA）是一种典型的自身免疫性疾病，其特征为慢性破坏性炎症性滑膜炎，可导致严重残疾和死亡。由于关节破坏在疾病早期就会发生，因此必须及时进行诊断和治疗。2010年类风湿关节炎分类标准通过关注疾病早期与持续性和/或侵蚀性疾病相关的特征，重新定义了当前的类风湿关节炎范式。因此，“达标治疗”的新概念正在类风湿关节炎治疗中兴起，即根据预先设定的目标（如缓解）对患者进行治疗。相应地，甲氨蝶呤与靶向肿瘤坏死因子（TNF）和白细胞介素-6（IL-6）的生物制剂联合使用，彻底改变了类风湿关节炎的治疗方式，在临床和结构结局方面取得了显著改善，并产生了作为临床和结构缓解的新的治疗终点。
