Understanding emerging treatment paradigms in rheumatoid arthritis 英文参考文献.docVIP

Breedveld and Combe Arthritis Research Therapy 2011, 13(Suppl 1):S3 /content/13/S1/S3 REVIEW Understanding emerging treatment paradigms in rheumatoid arthritis Ferdinand C Breedveld * and Bernard Combe 1 2 damage [1]. As most joint damage is largely irreversible, persistent damage will inevitably result in greater Abstract Treatment strategies for rheumatoid arthritis (RA) will continue to evolve as new drugs are developed, as new data become available, and as our potential to achieve greater and more consistent outcomes becomes more routine. Many patients will ?nd both symptom relief and modest control of their disease with disease-modifying antirheumatic drugs (DMARDs), yet this course of therapy is clearly not e?ective in all patients. In fact, despite strong evidence that intensive treatment in the early stages of RA can slow or stop disease progression and may prevent disability, many patients continue to be managed in a stepwise manner and are treated with an ongoing monotherapy regimen with DMARDs. There is now a large body of evidence demonstrating the success of treating RA patients with anti-TNF therapy, usually in combination with methotrexate. As a result of the increased use of anti-TNF therapy, treatment paradigms have changed – and our practice is beginning to re?ect this change. In the present review, we summarize the salient points of several recently proposed and emerging treatment paradigms with an emphasis on how these strategies may impact future practice. disa e treatment goals in RA therefore include [2,3]: prevention or control of joint damage; prevention of disease progression; prevention of loss of joint func- tion; a decrease of symptoms (for example, pain and sti? ness), and achievement of remission or low disease activity; improvement in quality of life (QoL) and main- tenance of lifestyle; achievement of drug-free remission; and rapid c