在关节痛中预防类风湿性关节炎:幻想还是现实?
Hanna W van Steenbergen1, Andrew P Cope2, Annette H M van der Helm-van Mil3,4
1Department of Rheumatology, Leiden University Medical Centre, Leiden, the Netherlands. h.w.van_steenbergen@lumc.nl.
Nature reviews. Rheumatology
|October 9, 2023
概括
在关节痛的早期阶段治疗类风湿性关节炎 (RA) 有好处,即使RA没有发展. 然而,需要更多的研究来识别高风险个体并有效指导治疗持续时间.
科学领域:
- 类风湿病学 类风湿病学
- 临床免疫学临床免疫学
- 翻译医学是一种翻译医学.
背景情况:
- "机会之窗"的概念表明,早期干预可以永久地改变疾病的发展轨迹.
- 风湿性关节炎 (RA) 治疗在临床症状和诊断之前可能最有效.
- 在RA诊断之前的关节痛阶段是预防性治疗策略的目标.
研究的目的:
- 审查在RA关节痛阶段研究治疗的概念验证试验.
- 评估早期RA干预的结果,考虑患者的观点.
- 讨论临床翻译挑战和RA"机会窗口"干预的未来研究需求.
主要方法:
- 在RA关节炎中完成的概念验证试验的审查.
- 对治疗结果和患者报告的益处的分析.
- 讨论影响临床实践和未来研究方向的因素.
主要成果:
- 大多数风险较高的症状患者都从固定治疗期中受益,不论RA的发展如何.
- 早期干预显示出持续减少疾病负担的潜力.
- 患者的观点强调了前关节炎阶段主动管理的价值.
结论:
- 在RA关节炎阶段的干预对处于危险阶段的个体可能是有益的.
- 临床实施需要更好的风险分层和监测治疗持续时间的工具.
- 进一步的证据对于优化早期RA治疗和避免意外后果至关重要.
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