...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Rheumatology >Optimal use of non-biologic therapy in the treatment of rheumatoid arthritis
【24h】

Optimal use of non-biologic therapy in the treatment of rheumatoid arthritis

机译：最佳使用非生物疗法治疗类风湿关节炎

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

With the evolution of therapies for RA, new treatment strategies and goals of therapy have evolved. Recent European League Against Rheumatism (EULAR) guidelines on the treatment of RA proposed three phases of therapy: phase I comprising first-line synthetic DMARD with or without glucocorticoid; phase II comprising second-line synthetic DMARD with or without glucocorticoid, or combination synthetic DMARD therapy, or (if prognostic factors are poor) first-line biologic DMARD; and phase III comprising alternative biologic DMARDs. In all phases, the key principle is tight control: striving to achieve a predefined goal of remission or low disease activity (treat to target) with frequent dose and medication adjustments tailored to the individual patient, preferably within the window of opportunity during early RA. In all phases, MTX is recognized as an anchor drug; it is characterized by proven efficacy in combination DMARD strategies, relatively low cost, relatively rapid onset of action, proven beneficial impact on radiological progression and mortality and a wide dose range that facilitates dose adjustments. Prednisone and its active metabolite, prednisolone, have similar characteristics, making them ideal anchor drugs too. The EULAR guidelines reserve a place for MTX and glucocorticoids in all phases of treatment. The second CAMERA (Computer Assisted Management in Early Rheumatoid Arthritis) study in early RA has demonstrated that including prednisone from the start in an MTX-based tight control strategy aimed at remission improves disease activity variables, time to remission, functional disability and radiological joint damage compared with the same strategy without prednisone. In conclusion, both MTX and prednisone play key roles in modern RA treatment strategies.
机译：随着RA疗法的发展，新的治疗策略和治疗目标已经发展。最近的欧洲风湿病联盟（EULAR）治疗RA的指南提出了三个治疗阶段：第一阶段包括一线合成DMARD，含或不含糖皮质激素;第二阶段，包括使用或不使用糖皮质激素的二线合成DMARD，或联合合成DMARD治疗，或（如果预后因素较差）一线生物DMARD;第三阶段包括替代性生物DMARD。在所有阶段，关键原则都是严格控制：通过针对个体患者的频繁剂量和药物调整，努力实现缓解或疾病活动度低（从治疗到目标）的预定目标，最好在RA早期的机会之内。在所有阶段，MTX被认为是锚定药物。它的特点是在DMARD联合治疗策略中具有公认的功效，相对较低的成本，相对较快的起效，对放射学进展和死亡率的公认有益影响以及广泛的剂量范围，有利于剂量调整。泼尼松及其活性代谢物泼尼松龙具有相似的特性，也使其成为理想的锚定药物。 EULAR指南在所有治疗阶段均为MTX和糖皮质激素预留了位置。 RA早期的第二项CAMERA（类风湿关节炎早期计算机辅助管理）研究表明，从一开始就将泼尼松纳入基于MTX的旨在缓解的严格控制策略中，可以改善疾病活动性变量，缓解时间，功能障碍和放射学关节损伤与没有泼尼松的相同策略相比。总之，MTX和泼尼松在现代RA治疗策略中均起着关键作用。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号