Krüger K
Rheumatologisches Praxiszentrum München, St.-Bonifatius-Str. 5, 81541, München, Deutschland.
Internist (Berl). 2018 Apr;59(4):341-351. doi: 10.1007/s00108-018-0397-2.
Due to therapeutic advances, rheumatoid arthritis (RA) today has developed into a satisfactorily treatable disease in most cases, with remission being the target of treatment. Early diagnosis with immediate treatment initiation following treat-to-target strategy is the key to a favorable long-term outcome. A guideline-directed treatment algorithm determines the use of conventional synthetic disease-modifying anti-rheumatic drugs (DMARD; e.g., methotrexate), biological DMARD, and targeted oral DMARD (Janus kinase inhibitors). Comorbidities-in particular cardiovascular and interstitial lung disease-affect 80% of RA patients and represent the leading causes for mortality. The choice of drug treatment is influenced by the presence of comorbidities.
由于治疗方面的进展，如今类风湿性关节炎（RA）在大多数情况下已发展成为一种可得到满意治疗的疾病，缓解是治疗目标。按照达标治疗策略尽早诊断并立即开始治疗是取得良好长期预后的关键。基于指南的治疗方案决定了传统合成改善病情抗风湿药（DMARD，如甲氨蝶呤）、生物DMARD和靶向口服DMARD（Janus激酶抑制剂）的使用。合并症，尤其是心血管疾病和间质性肺病，影响着80%的RA患者，是主要死因。合并症的存在会影响药物治疗的选择。
