类风湿性关节炎 类风湿性关节炎 类风湿性关节炎
David L Scott1, Frederick Wolfe, Tom W J Huizinga
1Department of Rheumatology, King's College London School of Medicine, London, UK. d.scott@nhs.net
Lancet (London, England)
|September 28, 2010
概括
类风湿性关节炎涉及持续的炎症和自身抗体,遗传和吸烟是关键的危险因素. 像DMARDs和生物药物等有效的治疗方法旨在控制炎症并防止关节损伤.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 遗传学 是一个遗传学.
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性自身免疫性疾病,其特征是肌膜炎,全身炎症和自身抗体.
- 遗传因素占RA风险的50%,吸烟是主要的环境触发因素.
- 在工业化国家,RA影响0.5-1.0%的成年人,主要是女性和老年人,导致关节损伤和并发症.
研究的目的:
- 概述了类风湿性关节炎的特征,危险因素和当前治疗策略.
- 讨论疾病修饰性抗风湿药物 (DMARD) 和生物药物在治疗RA中的作用.
- 突出通过有针对性的,密集的治疗来实现长期缓解的最终目标.
主要方法:
- 对现有关于类风湿性关节炎病理生理学和治疗的文献的综述.
- 对有关RA患病率和发病率的流行病学数据的分析.
- 讨论DMARDs和生物疗法的机制和临床应用.
主要成果:
- 类风湿性关节炎是导致残疾和生活质量下降的重要原因,与心血管风险增加有关.
- 甲托雷克萨特是主要的DMARD,通常用于组合疗法.
- 生物药物,包括TNF抑制剂,阿巴塔塞普特,瑞图西马布和托西利祖马布,对于耐火性RA是有效的,但由于感染风险和成本而面临限制.
结论:
- 类风湿性关节炎的有效治疗需要控制肌炎和全身炎症,以防止关节损伤并改善患者的治疗结果.
- 以生物标志物为指导的向疗法的开发有望实现类风湿性关节炎的长期缓解.
- 将治疗效率与安全问题和成本相平衡,对于先进的RA疗法的广泛应用至关重要.
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