Division of Rheumatic Diseases, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8884, USA,
Curr Rheumatol Rep. 2013 Nov;15(11):370. doi: 10.1007/s11926-013-0370-y.
Increasing evidence suggests low disease activity or remission is achievable in rheumatoid arthritis (RA). Using a treat to target strategy (T2T) has been shown to achieve these targets of remission or low disease activity in RA. In order to successfully treat to target, rheumatologists need reliable measures of disease activity to switch and/or escalate therapy to achieve or maintain therapeutic targets. Multiple disease-activity measures have been developed for both research and clinical practice. For clinical practice, the American College of Rheumatology (ACR) has recommended the PAS, PAS II, RAPID 3, CDAI, DAS 28, and SDAI for measuring disease activity in rheumatoid arthritis. Each of these measures has strengths and limitations, but they all accurately reflect disease activity, discriminate well between disease states, and are feasible to perform in the clinical setting. Implementation in the clinical setting can be optimized through leveraging technology and systems redesign. Tools such as web-based and smartphone applications have been developed to increase the ease with which these measures can be deployed. Disease-activity measurement in rheumatoid arthritis is included in the rheumatoid arthritis quality measures group in the Centers for Medicare and Medicaid Services' incentive-based Physician Quality Reporting System.
越来越多的证据表明，类风湿关节炎（RA）可以实现低疾病活动度或缓解。采用靶向治疗策略（T2T）已被证明可以达到 RA 缓解或低疾病活动度的这些目标。为了成功地靶向治疗，风湿病学家需要可靠的疾病活动度衡量标准来切换和/或升级治疗，以实现或维持治疗目标。已经为研究和临床实践开发了多种疾病活动度衡量标准。对于临床实践，美国风湿病学会（ACR）推荐 PAS、PAS II、RAPID 3、CDAI、DAS 28 和 SDAI 来衡量类风湿关节炎的疾病活动度。这些措施各有优缺点，但都能准确反映疾病活动度，很好地区分疾病状态，并且在临床环境中可行。通过利用技术和系统重新设计，可以优化在临床环境中的实施。已经开发了基于网络和智能手机的应用程序等工具，以增加这些措施的部署便利性。类风湿关节炎的疾病活动度测量被纳入医疗保险和医疗补助服务中心基于激励的医师质量报告系统中的类风湿关节炎质量测量组。
