Yang Min, Guo Mingyang
Rheumatology Center, PLA General Hospital of Chengdu Military Area Command, Chengdu, Sichuan Province, PR China.
Open Access Rheumatol. 2012 Jul 9;4:81-86. doi: 10.2147/OARRR.S32493. eCollection 2012.
Although treat-to-target goals for rheumatoid arthritis (RA) have been well-established through several guidelines in recent years, concerns regarding treat-to-prevent goals for RA remain unclear. RA patients are typically subjected to over- or under-treatment because it is difficult for clinicians to determine the prognosis of RA patients. This typically results in failure to select and identify patient subsets that should receive monotherapy or combination therapy to treat early RA. Understanding treat-to-prevent goals, as well as unfavorable prognoses, risk factors, and prediction methods for RA, is therefore critical for making treatment decisions. Rapid radiographic progression plays a central role in contributing to other composite RA indices, so this may be the best method for defining treat-to-prevent goals for RA. Accordingly, risk factors of rapid radiographic progression have been defined and two prediction models were retrospectively derived based on clinical trial data. Additional studies are required to develop risk models that can be used for accurate predictions.
尽管近年来通过多项指南已明确确立了类风湿关节炎（RA）的治疗达标目标，但对于RA的治疗预防目标仍不明确。RA患者通常会接受过度或不足的治疗，因为临床医生很难确定RA患者的预后。这通常导致无法选择和识别应接受单药治疗或联合治疗以治疗早期RA的患者亚组。因此，了解治疗预防目标以及RA的不良预后、危险因素和预测方法对于做出治疗决策至关重要。快速影像学进展在其他综合RA指标中起着核心作用，因此这可能是定义RA治疗预防目标的最佳方法。相应地，已确定了快速影像学进展的危险因素，并根据临床试验数据回顾性推导了两个预测模型。还需要进行更多研究来开发可用于准确预测的风险模型。
