Burgos-Vargas Rubén, Catoggio Luis Jose, Galarza-Maldonado Claudio, Ostojich Kasmir, Cardiel Mario H
Department of Rheumatology, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico.
Reumatol Clin. 2013 Mar-Apr;9(2):106-12. doi: 10.1016/j.reuma.2012.09.001. Epub 2013 Jan 20.
Rheumatoid arthritis (RA) is a systemic inflammatory disease affecting the synovium of joints, tendons, and some extra-articular sites. RA prevalence in Latin America ranges from 0.4 to 1.6%. Early treatment of RA translates into a substantial reduction in the cost to society. In light of this, early disease clinics are being established in some countries. Barriers to RA management, such as delay in referral to rheumatologists and limited access to therapy, have been identified. Evidence-based treatment guidelines have been adapted by countries according to their own situations. The need for keeping accurate records of biologics prescribed has been addressed by biologic registries, thereby contributing toward a better understanding of rheumatic diseases and their treatment. Current biologics include the tumor necrosis factor (TNF)-α inhibitors (etanercept, infliximab, and adalimumab), B-cell depletion agent (rituximab), interleukin-6 receptor blocker (tocilizumab), and T-cell co-stimulatory blocker (abatacept). Future therapies include kinase inhibitors (tofacitinib and fostamatinib), alternative TNF-α inhibitors (golimumab and certolizumab), and biosimilars.
类风湿关节炎(RA)是一种全身性炎症性疾病,会影响关节滑膜、肌腱以及一些关节外部位。拉丁美洲的类风湿关节炎患病率在0.4%至1.6%之间。类风湿关节炎的早期治疗可大幅降低社会成本。鉴于此,一些国家正在设立早期疾病诊所。已发现类风湿关节炎管理方面存在障碍,如转诊至风湿病专家的延迟以及治疗机会有限。各国已根据自身情况调整了循证治疗指南。生物制剂注册机构解决了准确记录所开生物制剂的需求,从而有助于更好地了解风湿性疾病及其治疗方法。目前的生物制剂包括肿瘤坏死因子(TNF)-α抑制剂(依那西普、英夫利昔单抗和阿达木单抗)、B细胞清除剂(利妥昔单抗)、白细胞介素-6受体阻滞剂(托珠单抗)和T细胞共刺激阻滞剂(阿巴西普)。未来的治疗方法包括激酶抑制剂(托法替布和福斯他替尼)、新型TNF-α抑制剂(戈利木单抗和赛妥珠单抗)以及生物类似药。