Hügle Thomas
Service de rhumatologie, CHUV, 1011 Lausanne.
Rev Med Suisse. 2021 Jan 27;17(723):214-218.
In 2020, clinical studies have opened the way for several new treatment options in rheumatoid arthritis, psoriasis arthritis, spondylarthritis and lupus. However, this year was mainly characterized by the Covid-19 pandemic which had a substantial impact on rheumatology. The initial fear for immune-compromised patients undergoing more severe Covid-19 courses remained without evidence. The same was true for the hype of several rheumatic treatments such as Plaquenil or anti-IL-6 blockade which finally did not show efficacy in prospective trials for Covid-19 pneumonia. On the other side, notably the first confinement had a substantial negative impact on rheumatic patients. Our patients are still struggling with the consequences of prolonged immobilization, lack of physiotherapy, missing consultations and treatment adaption as well as social isolation and depression. Telemedicine and upcoming digital solutions compensated this gap at least partially. The post-Covid syndrome with persisting fibromyalgia-like symptoms potentially will join the spectrum of rheumatic disorders.
2020年，临床研究为类风湿性关节炎、银屑病关节炎、脊柱关节炎和狼疮的几种新治疗方案开辟了道路。然而，今年的主要特征是新冠疫情，它对风湿病学产生了重大影响。最初对免疫功能低下患者会经历更严重新冠病程的担忧并无证据。对于几种风湿治疗方法（如羟氯喹或抗白细胞介素-6阻断）的炒作也是如此，这些方法最终在前瞻性的新冠肺炎试验中未显示出疗效。另一方面，值得注意的是，首次封锁对风湿患者产生了重大负面影响。我们的患者仍在与长期固定不动、缺乏物理治疗、错过会诊和治疗调整以及社会隔离和抑郁的后果作斗争。远程医疗和即将出现的数字解决方案至少部分弥补了这一差距。伴有持续纤维肌痛样症状的新冠后综合征可能会加入风湿性疾病的范畴。
