Department of Rheumatology and Internal Medicine, "Sf. Maria" Hospital, University of Medicine and Pharmacy "Carol Davila", 37-39 Ion Mihalache Blv, Sector 1, 011172 Bucharest, Romania.
Rheumatol Int. 2013 Jun;33(6):1379-86. doi: 10.1007/s00296-012-2629-4. Epub 2013 Jan 9.
Rheumatoid arthritis (RA) is a chronic, systemic, progressive inflammatory disease that, if left untreated, can lead to irreversible joint damage and serious disability. In Central and Eastern Europe, RA treatment varies widely, partly due to economic factors, restrictive treatment guidelines, and access to practicing rheumatologists. The recent treatment paradigm shift of treating to target in RA with early, aggressive therapy has proven to be a successful strategy for achieving optimal clinical outcomes. Several clinical studies demonstrate that utilizing this strategy with anti-tumor necrosis factor biologics leads to improved clinical, radiographic, and functional outcomes. Patient education is also a critical component of the treating to target strategy, and the patient's version of the treat-to-target recommendations is an important tool for successful implementation. This review discusses the evidence for the treat-to-target approach and describes areas to improve the disparity of treatment between patients in Western European compared with Central and Eastern European countries.
类风湿关节炎（RA）是一种慢性、全身性、进行性炎症性疾病，如果不进行治疗，可能会导致不可逆转的关节损伤和严重残疾。在中东欧，RA 的治疗方法存在很大差异，部分原因是经济因素、限制治疗指南以及可获得的执业风湿病专家的数量。最近的治疗范例转变为针对 RA 的靶向治疗，采用早期、积极的治疗策略已被证明是实现最佳临床结果的成功策略。多项临床研究表明，采用这种策略联合抗肿瘤坏死因子生物制剂可改善临床、影像学和功能结果。患者教育也是靶向治疗策略的关键组成部分，患者版的治疗目标建议是成功实施的重要工具。本文讨论了靶向治疗方法的证据，并描述了在西欧和中东欧国家之间改善患者治疗差异的领域。
