Division of Immunology and Rheumatology, Stanford University, Palo Alto, CA, USA.
Division of Rheumatology, Cedars-Sinai Medical Center, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
Clin Rheumatol. 2020 May;39(5):1379-1381. doi: 10.1007/s10067-020-05016-4. Epub 2020 Mar 13.
Rheumatoid arthritis (RA) is the most prevalent cause of chronic arthritis worldwide and contributes substantial health burden and socioeconomic costs, issues that are magnified by the aging population. Despite significantly improved outcomes in the management of RA with earlier diagnosis and advances in treatment, there is still no cure and disease prevention remains an area of intense interest. Studies examining different treatment regimens in varied subsets of patients with pre-clinical RA have been able to delay but not prevent onset of frank RA. In this timely issue of Clinical Rheumatology, Alpziar-Rodriguez D. and Finckh A. highlight the available literature on pre-clinical RA including modifiable risk factors, results of key intervention trials, and discuss whether prevention of RA is on the horizon. We offer additional thoughts on current areas of uncertainty in RA prevention studies, lessons to be learned from prevention trials in other disease states, and future directions to consider.
类风湿关节炎（RA）是全球最常见的慢性关节炎病因，给健康和社会经济带来了巨大负担，而人口老龄化使这一问题更加严重。尽管通过早期诊断和治疗进展，RA 的管理取得了显著改善，但仍无法治愈，疾病预防仍然是一个热点。研究人员对不同亚组的临床前 RA 患者进行了不同治疗方案的研究，这些研究能够延缓但不能预防典型 RA 的发生。在本期《临床风湿病学》中，Alpziar-Rodriguez D. 和 Finckh A. 强调了临床前 RA 的相关文献，包括可改变的危险因素、关键干预试验的结果，并讨论了 RA 预防是否即将成为现实。我们还对 RA 预防研究中的当前不确定性领域、从其他疾病状态的预防试验中吸取的经验教训以及未来需要考虑的方向提出了一些看法。
