Blank Rebecca B, Nwawka Ogonna Kenechi, Yusov Anna A, Gordon Jessica K
NewYork-Presbyterian/Weill Cornell Medicine Center, New York, NY, USA.
Hospital for Special Surgery, New York, NY, USA.
J Scleroderma Relat Disord. 2019 Feb;4(1):3-16. doi: 10.1177/2397198318779532. Epub 2018 Jun 19.
Musculoskeletal involvement, including arthritis and tendinopathy, is a common and important determinant of disability and impaired quality of life in systemic sclerosis. However, the treatment of arthritis in systemic sclerosis has not been studied as a primary outcome in randomized controlled trials, and arthritis-specific outcome measures for systemic sclerosis have not been sufficiently validated to date. Rheumatologists caring for patients with systemic sclerosis must address these complaints regularly despite the fact that the level of evidence for the treatment of systemic sclerosis-related inflammatory arthritis is limited. Consensus statements, based on treatments for related musculoskeletal aspects of rheumatoid arthritis, systemic lupus erythematosus, and other autoimmune diseases, support the use of methotrexate and hydroxychloroquine. Newer biologics, which have efficacy in the treatment of other autoimmune conditions, may show promise in the treatment of arthritis in systemic sclerosis. In this article, we review the current literature on the assessment and treatment of systemic sclerosis arthritis in order to address management considerations.
肌肉骨骼受累，包括关节炎和肌腱病，是系统性硬化症导致残疾和生活质量受损的常见且重要的决定因素。然而，系统性硬化症关节炎的治疗尚未作为随机对照试验的主要结局进行研究，并且系统性硬化症的关节炎特异性结局指标迄今尚未得到充分验证。尽管治疗系统性硬化症相关炎性关节炎的证据水平有限，但照顾系统性硬化症患者的风湿病学家仍必须定期处理这些症状。基于类风湿关节炎、系统性红斑狼疮和其他自身免疫性疾病相关肌肉骨骼方面的治疗的共识声明支持使用甲氨蝶呤和羟氯喹。在治疗其他自身免疫性疾病方面有效的新型生物制剂可能在系统性硬化症关节炎的治疗中显示出前景。在本文中，我们综述了当前关于系统性硬化症关节炎评估和治疗的文献，以探讨管理方面的考虑因素。
