Hen Or, Harrison Stephanie R, De Marco Gabriele, Marzo-Ortega Helena
NIHR Leeds Biomedical Research Centre, The Leeds Teaching Hospitals NHS Trust, Leeds.
Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
Ther Adv Musculoskelet Dis. 2024 Jul 27;16:1759720X241266727. doi: 10.1177/1759720X241266727. eCollection 2024.
Despite significant advances in the treatment of psoriatic arthritis (PsA) in the last two decades, remission remains elusive and there is no cure. Evidence from rheumatoid arthritis (RA) confirming enhanced response and outcome from earlier treatment intervention suggests the plausibility of the window of opportunity in the pathogenesis of RA. Yet, data are lacking in PsA. Although treatment response may be enhanced in shorter disease duration, it is unknown how this early intervention may impact long-term outcomes. Furthermore, it remains to be demonstrated whether there is a best treatment strategy and time of intervention. Crucially, the main hurdle when aiming for early treatment intervention is the ability to achieve a timely diagnosis that highlights the need to focus research efforts on characterizing the very early disease stages including the transition to PsA in the at-risk psoriasis population.
尽管在过去二十年中银屑病关节炎（PsA）的治疗取得了显著进展，但缓解仍然难以实现，且无法治愈。类风湿关节炎（RA）的证据表明，早期治疗干预可增强反应并改善预后，这提示了RA发病机制中存在机会窗的可能性。然而，PsA方面的数据尚缺乏。虽然疾病持续时间较短时治疗反应可能会增强，但早期干预如何影响长期预后尚不清楚。此外，是否存在最佳治疗策略和干预时机仍有待证明。至关重要的是，旨在进行早期治疗干预的主要障碍是能否及时做出诊断，这凸显了将研究重点放在表征疾病极早期阶段的必要性，包括高危银屑病人群向PsA的转变。
