Early Rheumatoid Arthritis

详细信息    查看全文

• 作者：Dr Amy C. Cannella (1)
  James R. O'Dell (1)
  
• 刊名：Drugs
• 出版年：2006
• 出版时间：July 2006
• 年：2006
• 卷：66
• 期：10
• 页码：1319-1337
• 全文大小：428KB
• 参考文献：1. Pincus T, Callahan LF, Sale WG, et al. Severe functional declines, work disability, and increased mortality in seventy-five rheumatoid arthritis patients studied over nine years. Arthritis Rheum 1984; 27: 864鈥?2
  2. Egsmose C, Lund B, Borg G, et al. Patients with rheumatoid arthritis benefit from early second-line therapy: 5-year follow-up of a prospective double-blind placebo-controlled study. J Rheumatol 1995; 22: 2208鈥?3
  3. Lard LR, Visser H, Speyer I, et al. Early versus delayed treatment in patients with recent-onset rheumatoid arthritis: comparison of two cohorts who received different treatment strategies. Am J Med 2001; 111: 446鈥?1
  4. Tsakonas E, Fitzgerald AA, Fitzcharles MA, et al. Consequences of delayed therapy with second-line agents in rheumatoid arthritis: a 3 year follow-up on the Hydroxychloroquine in Early Rheumatoid Arthritis (HERA) study. J Rheumatol 2000; 27: 623鈥?
  5. van der Heide A, Jacobs JW, Bijlsma JW, et al. The effectiveness of early treatment with 鈥榮econd-line鈥?antirheumatic drugs: a randomized, controlled trial. Ann Intern Med 1996; 124: 699鈥?07
  6. Boers M, Verhoeven AC, Markusse HM, et al. Randomized comparison of combined step-down prednisolone, methotrexate and suphasalazine with sulphasalazine alone in early rheumatoid arthritis [published erratum appears in Lancet 1998; 351: 220]. Lancet 1997; 350: 309鈥?8
  7. Calguneri M, Pay S, Caliskaner Z, et al. Combination therapy versus monotherapy for the treatment of patients with rheumatoid arthritis. Clin Exp Rheumatol 1999; 17: 699鈥?04
  8. Mottonen T, Hannonen P, Leirisalo-Repo M, et al. Comparison of combination therapy with single-drug therapy in early rheumatoid arthritis: a randomized trial. FIN-RACo trial group. Lancet 1999; 353: 1568鈥?3
  9. O'Dell JR, Haire CE, Erikson N, et al. Treatment of rheumatoid arthritis with methotrexate alone, sulfasalazine and hydroxychloroquine, or a combination of all three medications. N Engl J Med 1996; 334: 1287鈥?1
  10. O'Dell JR, Leff R, Paulsen G. Treatment of rheumatoid arthritis with methotrexate and hydroxychloroquine, methotrexate and sulfasalazine or a combination of three medications: results of a two-year, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2002; 46: 1164鈥?0
  11. Bathon JM, Martin RW, Fleischmann RM, et al. A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis [published errata appear in N Engl J Med 2001; 344: 76; N Engl J Med 2001; 344: 240]. N Engl J Med 2000; 343: 1586鈥?3
  12. Baumgartner SW, Fleischmann RM, Moreland LW, et al. Etanercept (Enbrel) in patients with rheumatoid arthritis with recent onset versus established disease: improvement in disability. J Rheumatol 2004; 31: 1532鈥?
  13. Tugwell P, Oritiz Z. Rheumatoid arthritis: emerging evidence for the benefits of early and aggressive therapy. Dis Manage Health Outcomes 1997; 3: 141鈥?3
  14. van der Heide DM. Joint erosions and patients with early rheumatoid arthritis. Br J Rheumatol. 1995; 34 Suppl. 2: 74鈥?
  15. Symmons DP, Jones MA, Scott DL, et al. Long-term mortality outcomes in patients with rheumatoid arthritis: early presenters continue to do well. J Rheumatol 1998; 25: 1072鈥?
  16. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315鈥?4
  17. Arendt FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of arthritis. Arthritis Rheum 1988; 31: 315鈥?24
  18. Aletaha D, Breedveld FC, Smolen JS. The need for new classification criteria for rheumatoid arthritis. Arthritis Rheum 2005; 52: 3333鈥?
  19. Harrison BJ, Symmons DP, Barrett EM, et al. The performance of the 1987 ARA classification criteria for rheumatoid arthritis in a population based cohort of patients with early inflammatory polyarthritis. J Rheumatol 1998; 25: 2324鈥?0
  20. Visser H, le Cessie S, Vos K, et al. How to diagnose rheumatoid arthritis early: a prediction model for persistent (erosive) arthritis. Arthritis Rheum 2002; 46: 357鈥?5
  21. Grassi W. Clinical evaluation versus ultrasonography: who is the winner? J Rheumatol 2003; 30: 908鈥?
  22. Schumacher HR, Pessler F, Chen LX. Diagnosing early rheumatoid arthritis (RA): what are the problems and opportunities? Clin Exp Rheumatol 2003; 21 (5 Suppl. 31): S15鈥揝9
  23. Ostergaard M, Szkudlarek M. Imaging in rheumatoid arthritis: why MRI and ultrasonography can no longer be ignored. Scand J Rheumatol 2003; 32: 63鈥?3
  24. Szkudlarek M, Narvestad E, Klarlund M, et al. Ultrasonography of the metatarsophalangeal joints in rheumatoid arthritis: comparison with magnetic resonance imaging, conventional radiography, and clinical examination. Arthritis Rheum 2004; 50: 2103鈥?2
  25. Forslind K, Larsson EM, Eberhardt K, et al. Magnetic resonance imaging of the knee: a tool for prediction of joint damage in early rheumatoid arthritis? Scand J Rheumatol 2004; 33: 154鈥?1
  26. Hoving JL, Buchbinder R, Hall S, et al. A comparison of magnetic resonance imaging, sonography, and radiography of the hand in patients with early rheumatoid arthritis. J Rheumatol 2004; 31: 663鈥?5
  27. Wakefield RJ, Karim Z, Conaghan PG, et al. Sonography is more sensitive than clinical examination at detecting synovitis in the metatarsophalangeal joints than clinical examination [abstract]. Arthritis Rheum 1999; 42: S352
  28. Keen HI, Emery P. How should we manage early rheumatoid arthritis? From imaging to intervention. Curr Opin Rheumatol 2005; 17: 280鈥?
  29. Strunk J, Lange U. Three-dimensional power Doppler sonographic visualization of synovial angiogenesis in rheumatoid arthritis. J Rheumatol 2004; 31: 1004鈥?
  30. Wakefield RJ, Kong KO, Conaghan PG, et al. The role of ultrasonography and magnetic resonance imaging in early rheumatoid arthritis. Clin Exp Rheumatol 2003; 21: S42鈥揝9
  31. Combe B, Dougados M, Goupille P, et al. Prognostic factors for radiographic damage in early rheumatoid arthritis: a multiparameter prospective study. Arthritis Rheum 2001; 44: 1736鈥?3
  32. Masi AT, Maldonado-Cocco JA, Kaplan SB, et al. Prospective study of the early course of rheumatoid arthritis in young adults: comparison of patients with and without rheumatoid factor positivity at entry and identification of variables correlating with outcome. Semin Arthritis Rheum 1976; 4: 299鈥?26
  33. Westedt ML, Herbrink P, Molenaar JL, et al. Rheumatoid factors in rheumatoid arthritis and vasculitis. Rheumatol Int 1985; 5: 209鈥?4
  34. Berglin E, Padyukov L, Sundin U, et al. A combination of autoantibodies to cyclic citrullinated peptide (CCP) and HLA-DRB1 locus antigens is strongly associated with future onset of rheumatoid arthritis. Arthritis Res Ther 2004; 6: 303鈥?
  35. Goldbach-Mansky R, Lee J, McCoy A, et al. Rheumatoid arthritis associated autoantibodies in patients with synovitis of recent onset. Arthritis Res 2000; 2: 236鈥?3
  36. Choy EH, Panayi GS. Cytokine Pathways and joint inflammation in rheumatoid arthritis. N Engl J Med 2001; 344: 907鈥?6
  37. Gonzalez-Gay MA, Garcia-Porrua C, Hajeer AH. Influence of human leukocyte antigen-DRB1 on the susceptibility and severity of rheumatoid arthritis. Semin Arthritis Rheum 2002; 31: 355鈥?0
  38. Gregersen PK, Silver J, Winchester RJ. The shared epitope hypothesis: an approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis. Arthritis Rheum 1987; 30: 1205鈥?13
  39. Shingu M, Nagai Y, Isayama T, et al. The effects of cytokines on metalloproteinase inhibitors (TIMP) and collagenase production by human cohondrocytes and TMP production by synovial cells and endothelial cells. Clin Exp Immunol 1993; 94: 145鈥?
  40. Girasole G, Passeri G, Jilka RL, et al. Interleukin-11: a new cytokine critical for osteoclast development. J Clin Invest 1994; 93: 1516鈥?4
  41. Cannella A, O'Dell J. Use of combination therapy for rheumatoid arthritis. J Musculoskeletal Med 2003; 20: 162鈥?0
  42. Harris ED Jr. The rationale for combination therapy of rheumatoid arthritis based on pathophysiology. J Rheumatol 1996; 23 Suppl. 44: 2鈥?
  43. Cannella AC, O'Dell JR. Is there still a role for traditional disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis? Curr Opin Rheumatol 2003; 15: 185鈥?2
  44. Felson DT, Anderson JJ, Meenan RF. The comparative efficacy and toxicity of second-line drugs in rheumatoid arthritis: results of two meta-analyses. Arthritis Rheum 1990; 33: 1449鈥?1
  45. Pincus T, Marcum SB, Callahan LF. Long-term drug therapy for rheumatoid art 1hritis in seven rheumatology private practices: second line drugs and prednisone. J Rheumatol 1992; 19: 1885鈥?4
  46. Wolfe F, Hawley DJ, Cathey MA. Termination of a slow acting antirheumatic therapy in rheumatoid arthritis: a 14 year prospective evaluation of 1017 consecutive starts. J Rheumatol 1990; 17: 994鈥?002
  47. Mikuls T, O'Dell JR. The treatment of rheumatoid arthritis: current trends in therapy [abstract]. Arthritis Rheum 1999; 42: S79
  48. O'Dell JR. Methotrexate use in rheumatoid arthritis. Rheum Dis Clin North Am 1997; 23: 779鈥?6
  49. Williams HJ, Willkens RF, Samuelson CO Jr, et al. Comparison of low-dose oral pulse methotrexate and placebo in the treatment of rheumatoid arthritis: a controlled clinical trial. Arthritis Rheum 1985; 28: 721鈥?0
  50. Kremer JM. Safety, efficacy and mortality in a long-term cohort of patients with rheumatoid arthritis taking methotrexate: follow-up after mean of 13.3 years. Arthritis Rheum 1997; 40: 984鈥?
  51. Morgan SL, Baggott JE, Vaughn WH, et al. Supplementation with folic acid during methotrexate therapy for rheumatoid arthritis: a double-blind, placebo controlled trial. Ann Intern Med 1994; 121: 833鈥?1
  52. Weinblatt M. Methotrexate (MTX) in rheumatoid arthritis (RA): a 5 year multi prospective trial [abstract]. Arthritis Rheum 1993; 36: S79
  53. Svartz N. Salazopyrin, a new sulfanilamide preparation. Acta Med Scand 1942; 110: 577
  54. Herman K, Leys A, Spileers W. (Hydroxy)-chloroquine retinal toxicity: two case reports and safety guidelines. Bull Soc Belge Ophtalmol 2002; 284: 21鈥?
  55. Smolen JS, Kalden JR, Scott DL, et al. Efficacy and safety of leflunomide compared with placebo and sulphasalazine in active rheumatoid arthritis: a double-blind randomized, multicenter trial. European Leflunomide Study Group. Lancet 1999; 353: 259鈥?6
  56. Strand V, Cohen S, Schiff M, et al. On behalf of the Leflunomide Rheumatoid Arthritis Investigators Group. Treatment of active rheumatoid arthritis with leflunomide compared with placebo and methotrexate. Arch Intern Med 1999; 159: 2542鈥?0
  57. O'Dell JR, Blakely KW, Mallek JA, et al. Treatment of early seropositive rheumatoid arthritis: a two-year, double-blind comparison of minocycline and hydroxychloroquine. Arthritis Rheum 2001; 44: 2235鈥?1
  58. O'Dell JR, Haire CE, Palmer W, et al. Treatment of early rheumatoid arthritis with minocycline or placebo. Arthritis Rheum 2002; 40: 842鈥?
  59. O'Dell JR, Paulsen G, Haire CE, et al. Treatment of early seropositive rheumatoid arthritis with minocycline: four-year followup of a double-blind, placebo-controlled trial. Arthritis Rheum 1999; 42: 1691鈥?
  60. Kirwan JR. The effect of glucocorticoid on joint destruction in rheumatoid arthritis: the Arthritis and Rheumatism Council Low-Dose Glucocorticoid Study Group. N Engl J Med 1995; 333: 142鈥?
  61. Kwoh CK, Anderson LG, Greene JM, et al. Guidelines for the management of rheumatoid arthritis. Arthritis Rheum 2002; 46: 328鈥?6
  62. Simms RW, Kwoh CK, Anderson LG, et al. Guidelines for monitoring drug therapy in rheumatoid arthritis: American College of Rheumatology Ad Hoc Committee on Clinical Guidelines. Arthritis Rheum 1996; 39: 723鈥?1
  63. van der Heijde DM, van't Hof M, van Riel PL, et al. Development of a disease activity score based on judgment in clinical practice by rheumatologists. J Rheumatol 1993; 20: 579鈥?1
  64. Felson DT, Anderson JJ, Boers M, et al. Preliminary definition of improvement in rheumatoid arthritis. American College of Rheumatology. Arthritis Rheum 1995; 38: 727鈥?5
  65. Paulus HE, Egger MJ, Ward JR, et al. Analysis of improvement in individual rheumatoid arthritis patients treated with disease-modifying antirheumatic drugs, based on the findings in patients treated with placebo: the Cooperative Systematic Studies of Rheumatic Diseases Group. Arthritis Rheum 1990; 33: 477鈥?4
  66. Scott DL. A simple index to assess disease activity in RA. J Rheumatol 1993; 20: 582鈥?
  67. van Gestel AM, Prevoo ML, van't Hof MA, et al. Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis: comparison with the Preliminary American College of Rheumatology and the World Health Organization/International League Against Rheumatism Criteria. Arthritis Rheum 1996; 39: 34鈥?0
  68. Tugwell P, Pincus T, Yocum D, et al. Combination therapy with cyclosporine and methotrexate in severe rheumatoid arthritis: the Methotrexate-Cyclosporine Combination Study Group. N Engl J Med 1995; 333: 137鈥?2
  69. Dougados M, Combe B, Cantagrel A, et al. Combination therapy in early rheumatoid arthritis: a randomised, controlled, double blind 52 week clinical trial of sulphasalazine and methotrexate compared with the single components. Ann Rheum Dis 1999; 58: 220鈥?
  70. Haagsma CJ, van Riel PL, de Jong AJ, et al. Combination of sulphasalazine and methotrexate versus the single components in early rheumatoid arthritis: a randomized, controlled, double-blind, 52 week clinical trial. Br J Rheumatol 1997; 36: 1082鈥?
  71. Landewe RB, Boers M, Verhoeven AC, et al. COBRA combination therapy in patients with early rheumatoid arthritis: long-term structural benefits of a brief intervention. Arthritis Rheum 2002; 46: 347鈥?6
  72. Pinals RS, Masi AT, Larsen RA, et al. Preliminary criteria for clinical remission in rheumatoid arthritis. Arthritis Rheum 1981; 24: 1308鈥?5
  73. Neva MH, Kauppi MJ, Kautiainen H, et al. Combination drug therapy retards the development of rheumatoid atlantoaxial subluxations. Arthritis Rheum 2000; 11: 2397鈥?01
  74. Elliot J, Maini R, Reldmann M, et al. Randomized double-blind comparison of chimeric monoclonal antibody to tumor necrosis factor alpha (eA2) versus placebo in rheumatoid arthritis. Lancet 1994; 344: 1101鈥?0
  75. Lipsky PE, van der Heijde DM, St Clair EW, et al. Infliximab and methotrexate in the treatment of rheumatoid arthritis: anti-tumor necrosis factor trial in rheumatoid arthritis with concomitant therapy study group. N Engl J Med 2000; 343: 1594鈥?02
  76. Maini RN, Breedveld FC, Kalden JR, et al. Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor alpha monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritis. Arthritis Rheum 1998; 41: 1552鈥?3
  77. Keystone E, Kavanaugh AF, Sharp J, et al. Adalimumab (D2E7), a fully human anti-tnf-alpha monoclonal antibody inhibits the progression of structural joint damage in patients with active RA despite concomitant methotrexate therapy [abstract]. Arthritis Rheum 2002; 46: S205
  78. Keystone E, Weinblatt M, Furst D, et al. The ARMADA trial: A double-blind placebo controlled trial of the fully human anti-TNF monoclonal antibody, adalimumab (D2E7) in patients with active RA on methotrexate (MTX) [abstract no. 965]. Arthritis Rheum 2001; 44: S213
  79. Van De Putte LBA, Atkins C, Malaise M, et al. Adalimumab (D2E7) monotherapy in the treatment of patients with rheumatoid arthritis. Arthritis Rheum 2002; 46: S205
  80. Moreland LW, Baumgartner SW, Schiff MH, et al. Treatment of rheumatoid arthritis with a recombinant human tumor necrosis factor receptor (p75)-Fc fusion protein. N Engl J Med 1997; 337: 141鈥?
  81. Weinblatt ME, Kremer JM, Bankhurst AD, et al. A trial of etanercept, a recombinant tumor necrosis factor receptor: Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate. N Engl J Med 1999; 340: 253鈥?
  82. Keane J. TNF-blocking agents and tuberculosis: new drugs illuminate an old topic. Rheumatology (Oxford) 2005; 44: 714鈥?0
  83. Mohan AK, Cote TR, Siegel JN, et al. Infectious complications of biologic treatments of rheumatoid arthritis. Curr Opin Rheumatol 2003; 15: 179鈥?4
  84. Favalli EG, Sinigaglia L, Varenna M, et al. Drug-induced lupus following treatment with infliximab in rheumatoid arthritis. Lupus 2002; 11: 753鈥?
  85. Hochberg MC, Lebwohl MG, Plevy SE, et al. The benefit/risk profile of TNF-blocking agents: findings of a consensus panel. Semin Arthritis Rheum 2005; 34: 819鈥?6
  86. Klippel JH. Biologic therapy for rheumatoid arthritis [published erratum appears in N Engl J Med 2001; 344:76]. N Engl J Med 2000; 343: 1640鈥?
  87. Shakoor N, Michalska M, Harris CA, et al. Drug-induced systemic lupus erythematosus associated with etanercept therapy. Lancet 2002; 359: 579鈥?0
  88. Brown SL, Greene MH, Gershon SK, et al. Tumor necrosis factor antagonist therapy and lymphoma development: twenty-six cases reported to the Food and Drug Administration. Arthritis Rheum 2002; 46: 3151鈥?
  89. Geborek P, Blastrom A, Turreson C, et al. Tumor necrosis factor blockers do not increase overall tumour risk in patients with rheumatoid arthritis, but may be associated with and increased risk of lymphomas. Ann Rheum Dis 2005; 64: 699鈥?03
  90. Baecklund E, Elkbom A, Sparen P, et al. Disease activity and risk of lymphoma in patients with rheumatoid arthritis: nested case-control study. BMJ 1998; 317: 180鈥?
  91. Felson DT, Anderson JJ, Lange ML, et al. Should improvement in rheumatoid arthritis clinical trials be defined as fifty percent or seventy percent improvement in core set measures, rather than twenty percent? Arthritis Rheum 1998; 41: 1564鈥?0
  92. Sharp JT, Lidsky MD, Collins LC, et al. Methods of scoring the progression of radiologic changes in rheumatoid arthritis: correlation of radiologic, clinical and laboratory abnormalities. Arthritis Rheum 1971; 14: 706鈥?0
  93. van der Heijde DM, van Leeuwen MA, van Riel PL, et al. Biannual radiographic assessments of hands and feet in the three-year prospective followup of patients with early rheumatoid arthritis. Arthritis Rheum 1991; 35: 26鈥?4
  94. Genovese MC, Bathon JM, Martin RW, et al. Etanercept versus methotrexate in patients with early rheumatoid arthritis: two-year radiographic outcomes. Arthritis Rheum 2002; 46: 1443鈥?0
  95. Emery P, Seto Y. Role of biologics in early arthritis. Clin Exp Rheumatol 2003; 21 (5 Suppl. 31): S191鈥?
  96. Klareskog L, van der Heijde D, de Jager JP, et al. TEMPO (Trial of Etanercept and Methotrexate with radiographic Patient Outcomes) study investigators. Therapeutic effect of the combination of etanercept and methotrexate compared with each treatment alone in patients with rheumatoid arthritis: double-blind randomised controlled trial. Lancet 2004; 363: 675鈥?1
  97. van der Heide A, Klareskog L, Wajdula J, et al. Halting of radiographic progression in RA patients treated with etanercept and methotrexate: year 2 results from the TEMPO trial [poster]. American College of Rheumatology Annual Meeting; 2004 Oct 16鈥?1; San Antonio (TX)
  98. St Clair EW, van der Heijde DM, Smolen JS, et al. Combination of infliximab and methotrexate therapy for early rheumatoid arthritis. Arthritis Rheum 2004; 50: 3432鈥?3
  99. van der Heijde DM. Plain x-rays in rheumatoid arthritis: overview of scoring methods, their reliability and applicability. Ballieres Clin Rheumatol 1996; 10: 435鈥?3
  100. Breedveld FC, Weisman MH, Kavanaugh AF, et al. A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early aggressive rheumatoid arthritis who had not had previous methotrexate treatment: the PREMIER study. Arthritis Rheum 2006; 54(1): 26鈥?7
  101. Pavelka K, Kvien TK, Cohen SB, et al. Failure to inhibit radiographic progression within the first 6 months of therapy leads to worse radiographic outcomes at 2 years. EULAR; 2005 Jun 8鈥?1; Vienna
  102. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt Study). Arthritis Rheum 2005; 52: 3381鈥?0
  103. Grigor C, Capell H, Stirling A, et al. Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled clinical trial. Lancet 2004; 364: 263鈥?
  104. O'Dell JR. Treating rheumatoid arthritis early: a window of opportunity? Arthritis Rheum 2002; 46: 283鈥?
  105. Quinn MA, Conaghan PG, O'Connor PJ, et al. Very early treatment with infliximab in addition to methotrexate in early, poor-prognosis rheumatoid arthritis reduces magnetic resonance imaging evidence of synovitis and damage, with sustained benefit after infliximab withdrawal. Arthritis Rheum 2005; 52: 27鈥?5
  106. Gossec L, Dougados M. Combination therapy in early rheumatoid arthritis. Clin Exp Rheumatol 2003; 21 (5 Suppl. 31): S174鈥?
  107. Smolen JS, Aletaha D, Keystone E. Superior efficacy of combination therapy for rheumatoid arthritis: fact or fiction? Arthritis Rheum 2005; 52(10): 2975鈥?3
  108. Bukhari M, Lunt M, Harrison BJ, et al. Rheumatoid factor is the major predictor of increasing severity of radiographic erosions in rheumatoid arthritis: results from the Norfolk Arthritis Register Study, a large inception cohort. Arthritis Rheum 2002; 46: 906鈥?2
  109. Forslind K, Ahlmen M, Eberhardt K, et al. Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP). Ann Rheum Dis 2004; 63: 1090鈥?
  110. Teitsson I. IgA rheumatoid factor as predictor of disease activity. Scand J Rheumatol Suppl 1988; 75: 233鈥?
  111. Harrison B, Symmons D. Early inflammatory polyarthritis: results from the Norfolk Arthritis Register with a review of the literature: II. Outcome at three years. Rheumatology 2000; 39: 939鈥?9
  112. O'Dell JR, Nepom BS, Haire C, et al. HLA-DRB1 typing in rheumatoid arthritis: predicting response to specific treatments. Ann Rheum Dis 1998; 57: 209鈥?3
  113. Lard LR, Boers M, Verhoeven A, et al. Early and aggressive treatment of rheumatoid arthritis patients affects the association of HLA class II antigens with progression of joint damage. Arthritis Rheum 2002; 46: 889鈥?05
  114. Sokka T, Pincus T. Eligibility of patients in routine care for major clinical trials of anti-tumor necrosis factor alpha agents in rheumatoid arthritis. Arthritis Rheum 2003; 48: 313鈥?
  115. Yazici Y, Erkan D. Eligibility of rheumatoid arthritis patients seen in clinical practice for rheumatoid arthritis clinical trials: comment on the article by Sokka and Pincus. Arthritis Rheum 2003; 48: 3611鈥?
  
• 作者单位：Dr Amy C. Cannella (1)
  James R. O'Dell (1)
  
  1. 983025 University of Nebraska Medical Center, Omaha, Nebraska, 68198-3025, USA
  

文摘

The treatment of rheumatoid arthritis (RA) has changed dramatically in the past decade as advancements in the understanding of the pathobiology of the disease have led to novel therapeutic agents. The recognition that early diagnosis and treatment leads to improvements in morbidity and mortality has altered the therapeutic strategy such that early therapy is now considered the standard of care. This review focuses on the challenges in making the diagnosis of early RA, including a broad differential diagnosis for inflammatory polyarthritis, poor performance of the standard classification criteria, difficulty in clinical assessment of synovitis, absence of absolute laboratory tests, inability of conventional radiography to detect bony changes early, and barriers to rheumatology care. Additionally, the pathogenesis of RA is highlighted, with particular emphasis on cytokine biology as it relates to therapeutic regimens. Relevant clinical trials in early RA are reviewed and discussed, including trials of combination disease-modifying antirheumatic drugs and biological therapy. The role of induction therapy as a novel therapeutic approach is highlighted. The search for predictors of response is reviewed and the external validity of the trials is analysed. Finally, the trials in early RA therapy suggest that swift intervention with combinations of medications is required for patients with severe RA. However, further research is needed to determine which regimen is appropriate for the individual patient with RA.