Emery P
Department of Rheumatology, University of Birmingham, Edgbaston.
Br J Rheumatol. 1993 Mar;32 Suppl 1:21-3.
In the past few years there has been considerable debate regarding the optimal therapy for patients with RA. The arguments have been phrased in a variety of ways and frequently involve the concept of therapy with multiple drugs. The underlying assumption is that current therapy is inadequate and that the whole therapeutic approach to RA needs rethinking. The evidence on which these assumptions are made is reviewed here. Additionally, this paper argues for a more discriminating approach using prognostic indicators to identify the minority of patients with persistent unresponsive disease (and poor outcome) for whom more aggressive therapy should be reserved.
在过去几年里，关于类风湿关节炎（RA）患者的最佳治疗方法存在大量争论。这些争论以多种方式表述，且常常涉及联合用药治疗的概念。其潜在假设是当前的治疗方法并不充分，需要重新思考针对RA的整体治疗策略。本文将审视这些假设所依据的证据。此外，本文主张采用一种更具区分性的方法，利用预后指标来识别少数持续性无反应疾病（及预后不良）的患者，应为这些患者保留更积极的治疗方法。
