Ajeganova Sofia, Huizinga Tom
Leids Universitair Medisch Centrum, Albinusdreef 2, Leiden, 2300 RC, The Netherlands.
Leiden University Medical Center, Leiden, The Netherlands.
Ther Adv Musculoskelet Dis. 2017 Oct;9(10):249-262. doi: 10.1177/1759720X17720366. Epub 2017 Aug 2.
Sustained remission is an ultimate treatment goal in the management of patients with rheumatoid arthritis (RA). Historically the frequency of sustained remission was low but the frequency of achieved sustained remission is increasing over time. The last years' clinical studies of tight control targeted treatment and intervention trials of early use of intensive strategy suggest that these treatment strategies are associated with higher rates of sustained remission. Achievement of sustained remission, in particular but not limited to early sustained remission, can provide tapering and stopping disease-modifying antirheumatic drugs (DMARDs). With new treatment strategies drug-free sustained remission is becoming an achievable goal. Sustained remission is associated with improved outcomes in regard to function, patient-reported outcomes and survival. Drug-free sustained remission is characterized by normalized function ability and survival. Sustained remission and, in particular, drug-free sustained remission offer hope that early identification of patients with arthritis, early improved novel treatments and treatment with target to achieve remission may potentially transform the progressive course of RA disease and disrupt RA chronicity. In this review we summarize the recent evidence on sustained remission in patients with RA, treatment strategies to achieve sustained remission, management of patients in sustained remission and significance of sustained remission from the patient perspective.
持续缓解是类风湿关节炎（RA）患者治疗的最终目标。从历史上看，持续缓解的发生率较低，但随着时间的推移，实现持续缓解的频率在增加。近年来，针对严格控制的临床研究、靶向治疗以及早期使用强化策略的干预试验表明，这些治疗策略与更高的持续缓解率相关。实现持续缓解，特别是但不限于早期持续缓解，可以减少并停用改善病情抗风湿药（DMARDs）。随着新的治疗策略的出现，无药持续缓解正成为一个可实现的目标。持续缓解与功能、患者报告结局和生存率的改善相关。无药持续缓解的特征是功能能力和生存率正常化。持续缓解，尤其是无药持续缓解，为早期识别关节炎患者、早期改进新型治疗方法以及以实现缓解为目标的治疗提供了希望，这可能会改变RA疾病的进展过程并打破RA的慢性病程。在本综述中，我们总结了关于RA患者持续缓解的最新证据、实现持续缓解的治疗策略、处于持续缓解状态患者的管理以及从患者角度看持续缓解的意义。
