Taylor Peter C, Atzeni Fabiola, Balsa Alejandro, Gossec Laure, Müller-Ladner Ulf, Pope Janet
Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK.
Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy.
J Clin Med. 2021 Feb 1;10(3):509. doi: 10.3390/jcm10030509.
Comorbidities in patients with rheumatoid arthritis (RA) are often associated with poor health outcomes and increased mortality. Treatment decisions should take into account these comorbidities due to known or suspected associations with certain drug classes. In clinical practice, it is critical to balance potential treatment benefit against the possible risks for comorbidities as well as the articular manifestations of RA. This review summarises the current literature relating to prevalence and risk factors for the important comorbidities of cardiovascular disease, infections, lymphomas and nonmelanoma skin cancers in patients with RA. The impact on patient outcomes and the interplay between these comorbidities and the therapeutic options currently available, including tumour necrosis factor inhibitors and newer biological therapies, are also explored. As newer RA therapies are developed, and patients gain wider and earlier access to advanced therapies, in part due to the emergence of biosimilars, it is important to consider the prevention or treatment of comorbidities as part of the overall management of RA.
类风湿关节炎（RA）患者的合并症常与健康状况不佳及死亡率增加相关。由于已知或疑似与某些药物类别存在关联，治疗决策应考虑这些合并症。在临床实践中，平衡潜在治疗益处与合并症以及RA关节表现的可能风险至关重要。本综述总结了目前关于RA患者心血管疾病、感染、淋巴瘤和非黑色素瘤皮肤癌等重要合并症的患病率及危险因素的文献。还探讨了这些合并症对患者预后的影响以及它们与当前可用治疗选择（包括肿瘤坏死因子抑制剂和新型生物疗法）之间的相互作用。随着新型RA疗法的开发，以及患者更广泛、更早期地获得先进疗法，部分原因是生物类似药的出现，将合并症的预防或治疗作为RA整体管理的一部分很重要。
