综合管理和治疗不耐用的牛皮关节炎的共识定义:GRAPPA倡议
Fabian Proft1, Andre L Ribeiro2,3, Shikha Singla4
1Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, Berlin, Germany. Fabian.Proft@charite.de.
Nature reviews. Rheumatology
|November 27, 2025
概括
对复杂治疗性牛皮关节炎 (PsA) 和治疗不耐药性牛皮关节炎 (TR-PsA) 的新定义旨在标准化治疗后症状持续的患者的术语,改进研究和护理.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 皮肤病学 皮肤病学
背景情况:
- 牛皮关节炎 (PsA) 治疗的进步仍然使许多患者出现持续的症状和降低生活质量.
- 对抗治疗的PsA的不一致术语阻碍了研究的可比性,并导致治疗惯性.
研究的目的:
- 为复杂管理的PsA (C2M-PsA) 和治疗耐药的PsA (TR-PsA) 建立共识定义.
- 在研究和临床实践中为PsA患者分层提供标准化的框架.
主要方法:
- 牛皮和牛皮关节炎研究和评估小组 (GRAPPA) 工作组制定了共识定义.
- 定义考虑了持续的症状,治疗史 (包括生物/向合成DMARDs - b/tsDMARDs),并发症,心理社会因素和客观炎症.
主要成果:
- 难以管理的PsA (C2M-PsA) 被定义为尽管≥1b/tsDMARD,但症状持续,包括更广泛的管理挑战.
- 治疗不耐药的PsA (TR-PsA) 被定义为C2M-PsA的一个子集,失败≥3次治疗 (≥2b/tsDMARDs),有问题症状和客观炎症.
结论:
- 对C2M-PsA和TR-PsA的共识定义提供了一个共同的框架来标准化术语.
- 这些定义可以支持个性化的PsA护理,并在研究和实践中增强患者分层.
- 未来的验证是必要的,以确认这些定义的临床实用性.
相关概念视频
01:26Psychosis: Goals of Pharmacotherapy
446
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
446
01:26Atherosclerosis III: Management
296
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
296
01:21Rheumatic Heart Disease III: Medical Management
267
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
267
01:30Asthma-IV: Diagnostic and Management
3.0K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
3.0K
01:11Genome-wide Association Studies-GWAS
15.2K
Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
GWAS does not require the identification of the target gene involved in...
GWAS does not require the identification of the target gene involved in...
15.2K
01:20Myasthenia Gravis: Overview and Treatment
2.7K
Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
2.7K