Miedany Yasser El
Darent Valley Hospital, Dartford, Kent. UK.
Curr Rheumatol Rev. 2014;10(2):87-93. doi: 10.2174/1573397110666140301000430.
Recent publications have proposed revisions to disease classification criteria, new definitions of early diagnosis and remission, as well as guidelines for implementing treat-to-target strategies for the management of patients with spondyloarthritis. Despite developments leading to this practice-changing approach, the concept of treat to target for spondyloarthritis has not yet been widely accepted or implemented in standard clinical care. By placing greater emphasis on clinical features that manifest early in the disease process, the early and aggressive treatment of the most common forms of spondyloarthritis (namely ankylosing spondylitis and psoriatic arthritis), has been shown to have favorable patient outcomes in reducing synovial inflammation, delaying joint damage, and maintaining functional status. This article discusses the recent concept of Treat to Target in spondyloarthritis and the importance of early diagnosis of both ankylosing spondylitis (AS) and psoriatic arthritis (PsA). It also highlights the main outcome measures for spondyloarthritis patients achieving treatment goals of low levels of disease activity or clinical remission.
近期发表的文献提出了对疾病分类标准的修订、早期诊断和缓解的新定义，以及针对脊柱关节炎患者管理实施达标治疗策略的指南。尽管有这些发展促成了这种改变实践的方法，但脊柱关节炎的达标治疗概念在标准临床护理中尚未得到广泛接受或实施。通过更加强调在疾病过程早期出现的临床特征，已证明对最常见形式的脊柱关节炎（即强直性脊柱炎和银屑病关节炎）进行早期积极治疗，在减少滑膜炎症、延缓关节损伤和维持功能状态方面对患者有良好的治疗效果。本文讨论了脊柱关节炎达标治疗的最新概念以及强直性脊柱炎（AS）和银屑病关节炎（PsA）早期诊断的重要性。它还强调了脊柱关节炎患者实现低疾病活动水平或临床缓解治疗目标的主要疗效指标。
