Fazal Syed Ali, Khan Mohammad, Nishi Shamima E, Alam Fahmida, Zarin Nowshin, Bari Mohammad T, Ashraf Ghulam Md
Faculty of Entrepreneurship and Business, University Malaysia Kelantan, Kelantan, Malaysia.
Community Medicine, School of Dental Sciences, University Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
Endocr Metab Immune Disord Drug Targets. 2018 Feb 13;18(2):98-109. doi: 10.2174/1871530317666171114122417.
Rheumatoid arthritis (RA) is a predominant inflammatory autoimmune disorder. The incidence and prevalence of RA is increasing with considerable morbidity and mortality worldwide. The pathophysiology of RA has become clearer due to many significant research outputs during the last two decades. Many inflammatory cytokines involved in RA pathophysiology and the presence of autoantibodies are being used as potential biomarkers via the use of effective diagnostic techniques for the early diagnosis of RA. Currently, several disease-modifying anti-rheumatic drugs are being prescribed targeting RA pathophysiology, which have shown significant contributions in improving the disease outcomes.
Even though innovations in treatment strategies and monitoring are helping the patients to achieve early and sustained clinical and radiographic remission, the high cost of drugs and limited health care budgets are restricting the easy access of RA treatment. Both direct and indirect high cost of treatment are creating economic burden for the patients and affecting their quality of life.
The aim of this review is to describe the updated concept of RA pathophysiology and highlight current diagnostic tools used for the early detection as well as prognosis - targeting several biomarkers of RA. Additionally, we explored the updated treatment options with side effects besides discussing the global economic burden.
类风湿性关节炎（RA）是一种主要的炎症性自身免疫性疾病。在全球范围内，RA的发病率和患病率不断上升，具有相当高的发病率和死亡率。由于过去二十年的许多重大研究成果，RA的病理生理学已变得更加清晰。通过使用有效的诊断技术对RA进行早期诊断，许多参与RA病理生理学的炎性细胞因子和自身抗体的存在正被用作潜在的生物标志物。目前，针对RA病理生理学正在使用几种改善病情的抗风湿药物，这些药物在改善疾病结局方面已显示出显著作用。
尽管治疗策略和监测方面的创新正在帮助患者实现早期和持续的临床及影像学缓解，但药物的高成本和有限的医疗保健预算限制了RA治疗的可及性。治疗的直接和间接高成本都给患者造成了经济负担，并影响他们的生活质量。
本综述的目的是描述RA病理生理学的最新概念，突出用于早期检测以及针对RA多种生物标志物进行预后评估的当前诊断工具。此外，除了讨论全球经济负担外，我们还探讨了具有副作用的最新治疗选择。
