Academic Department of Rheumatology, King's College London School of Medicine, Weston Education Centre, London.
Clin Med (Lond). 2012 Aug;12(4):357-63. doi: 10.7861/clinmedicine.12-4-357.
Inflammatory arthritis involves a diverse range of conditions in which an uncontrolled immune response occurs. A number of advances in assessment, diagnosis and treatment have been made in recent years. Drug therapies used in inflammatory arthritis aim to reduce symptoms and suppress inflammation, joint damage and disability. In rheumatoid arthritis (RA), immunosuppression is used in almost all patients, with an emphasis on early aggressive treatment to achieve clinical remission. This approach is less successful in spondylarthropathies, for which non-steroidal anti-inflammatory drugs remain first-line therapy. The use of biologic therapies has increased dramatically across a range of indications and has resulted in improved outcomes for patients. These agents are associated with an increased risk of infection, particularly tuberculosis in patients receiving tumour necrosis factor inhibitors. Alternative biologics have entered clinical practice for RA in recent years, and clinical trials using these agents, as well as novel non-biologic therapies, are in progress for RA and other conditions.
炎症性关节炎涉及多种疾病，这些疾病的共同特征是免疫反应失控。近年来，在评估、诊断和治疗方面取得了许多进展。炎症性关节炎的药物治疗旨在减轻症状、抑制炎症、关节损伤和残疾。在类风湿关节炎（RA）中，几乎所有患者都使用免疫抑制治疗，强调早期积极治疗以实现临床缓解。这种方法在脊柱关节炎中效果较差，非甾体抗炎药仍然是一线治疗药物。生物治疗在各种适应证中的应用显著增加，为患者带来了更好的治疗效果。这些药物会增加感染的风险，尤其是接受肿瘤坏死因子抑制剂治疗的患者会增加结核病的风险。近年来，针对 RA 的其他生物制剂也已进入临床实践，使用这些药物以及新型非生物制剂治疗 RA 和其他疾病的临床试验正在进行中。
