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改善病情抗风湿药(DMARDs)对类风湿关节炎(RA)患者骨稳态的影响。

The effect of disease-modifying antirheumatic drugs (DMARDs) on bone homeostasis in rheumatoid arthritis (RA) patients.

作者信息

Khoshroo Ahmadreza, Ramezani Keyvan, Moghimi Niusha, Bonakdar Moein, Ramezani Nazanin

机构信息

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Orthopaedic Surgeon, Department of Orthopedics, Emam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Inflammopharmacology. 2023 Apr;31(2):689-697. doi: 10.1007/s10787-022-01088-7. Epub 2022 Nov 8.

Abstract

The autoimmune disease known as rheumatoid arthritis (RA) has been linked to the deterioration of bone. Bone erosion is a hallmark of RA and is linked to the severity of the disease as well as a poor functional result. Erosion of periarticular cortical bone is a common feature seen on plain radiographs of patients with RA. This characteristic feature is the result of excessive bone resorption and inadequate formation of bone. It has been determined that there is a complex interaction between the inflammatory condition seen in RA and bone destruction. Increased knowledge of the pathways and other mechanisms involved in osteoclastogenesis has resulted from advances in both animal and clinical investigations. Also, Biological and targeted medicines have modified RA's bone metabolism. Here, we provide a narrative overview of the literature on the pathomechanisms of bone structure involved in biological and targeted treatments for RA and also, the clinical implications of disease-modifying antirheumatic drugs (DMARDs) are discussed. In light of the fact that these newer treatments present patients with RA with new possibilities for disease improvement and symptom control, it is imperative that additional rigorous evidence be gathered to provide a clinical reference for both patients and their treating physicians.

摘要

被称为类风湿性关节炎(RA)的自身免疫性疾病与骨质恶化有关。骨侵蚀是类风湿性关节炎的一个标志,与疾病的严重程度以及功能预后不良有关。关节周围皮质骨的侵蚀是类风湿性关节炎患者X线平片上常见的特征。这一特征是骨吸收过多和骨形成不足的结果。已经确定,类风湿性关节炎中出现的炎症状况与骨破坏之间存在复杂的相互作用。动物和临床研究的进展使人们对破骨细胞生成所涉及的途径和其他机制有了更多的了解。此外,生物药和靶向药物已经改变了类风湿性关节炎的骨代谢。在此,我们对有关类风湿性关节炎生物治疗和靶向治疗中涉及的骨结构病理机制的文献进行叙述性综述,并讨论改善病情抗风湿药(DMARDs)的临床意义。鉴于这些新疗法为类风湿性关节炎患者带来了改善疾病和控制症状的新可能性,必须收集更多严格的证据,为患者及其治疗医生提供临床参考。

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