Early treatment in early undifferentiated arthritis

详细信息	查看全文 | 推荐本文 |

• 作者：Ignazio Olivieri^a ; ^{ignazioolivieri@tiscalinet.it} ; ^{i.olivieri@ospedalesancarlo.it} ; Piercarlo Sarzi-Puttini^b ; Serena Bugatti^c ; Fabiola Atzeni^b ; ^d ; Salvatore d'Angelo^a ; ^e ; Roberto Caporali^c
• 关键词：Rheumatoid arthritis ; Undifferentiated arthritis ; Early diagnosis ; Treatment
• 刊名：Autoimmunity Reviews
• 出版年：2012
• 期刊代码：30_15689972
• 类别：med
• 出版时间：June, 2012
• 卷：11
• 期：8
• 页码：589-592
• 文件大小：162 K

摘要

The early diagnosis of new-onset rheumatoid arthritis (RA) has become a major objective for rheumatologists in order to identify a management strategy able to change the natural history of the disease and to prevent joint damage and functional impairment. Emergent evidence emphasizes the benefits of early aggressive therapy of RA. By the nineties, early arthritis cohorts have been collected throughout the world with the aim to increase the early referral of patients with early onset disease by the general practitioners and to collect data on the development of full-blown RA. The frequency of undifferentiated arthritis (UA) ranged from 23%to 81%in these early cohorts with most of them reporting a rate of 30%. The transition rate from UA to RA was between 13%and 54%. A percentage of 20-60%of patients with UA had a self-limiting disease.

Our article deals with the controversy existing in the management of UA. Should every patient with UA be treated? Could patients with a favorable disease course be exposed to unnecessary risk with initiation of aggressive therapy with synthetic disease-modifying anti-rheumatic drugs (DMARDs) or biologic agents? The pros and cons of treating patients with UA are examined.