本文由小咖机器人翻译整理

期刊来源：BMJ

原文链接：https://doi.org/10.1136/bmj-2022-070856

摘要内容如下：

类风湿性关节炎（RA）是最常见的免疫介导的炎症性疾病之一。患有类风湿性关节炎的人表现为疼痛、肿胀和僵硬，通常影响对称分布的小关节和大关节。如果没有有效的治疗，由于关节衬里（滑膜）的慢性炎症，会发生严重的关节损伤、残疾和工作损失。在过去的25年里，这种情况的管理已经发生了革命性的变化，大大提高了疾病的缓解水平和更好的长期结果。这种改善反映了向早期和积极的药物干预的范式转变，以及治疗选择的增加，这反过来又与病理学理解的增强和治疗类风湿性关节炎的新药的出现有关。在从历史的角度对这些发展进行概述之后，并考虑到普通受众，本综述重点关注不断发展的环境中的新的、有针对性的治疗方法。审查强调了正在进行辩论的领域和未满足的需求，包括患有持续、难以治疗的疾病的患者比例，尽管最近取得了进展。还讨论了针对个体患者的个性化战略方法，成像在临床决策中的作用，以及未来持续、无药物缓解和疾病预防的目标。

英文原文如下：

Abstracts

Rheumatoid arthritis (RA) is one of the most common immune mediated inflammatory diseases. People with rheumatoid arthritis present with pain, swelling, and stiffness that typically affects symmetrically distributed small and large joints. Without effective treatment, significant joint damage, disability, and work loss develop, owing to chronic inflammation of the joint lining (synovium). Over the past 25 years, the management of this condition has been revolutionized, resulting in substantially higher levels of disease remission and better long term outcomes. This improvement reflects a paradigm shift towards early and aggressive pharmacological intervention coupled with a proliferation in treatment choice, in turn related to enhanced pathobiological understanding and the advent of new drugs for rheumatoid arthritis. Following an overview of these developments from a historical perspective, and with a general audience in mind, this review focuses on newer, targeted treatments in an ever evolving landscape. The review highlights ongoing areas of debate and unmet need, including the proportion of patients with persistent, difficult-to-treat disease, despite recent advances. Also discussed are personalized, strategic approaches to individual patients, the role for imaging in clinical decision making, and the goal of sustained, drug free remission and disease prevention in the future.

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