当前位置： SCI文献检索 > CLINICAL AND EXPERIMENTAL RHEUMATOLOGY期刊下所有文献 > Can remission be maintained with or without further drug therapy in rheumatoid arthritis?

Can remission be maintained with or without further drug therapy in rheumatoid arthritis?

Abstract：

:Remission is now the accepted goal of management in rheumatoid arthritis (RA). This article highlights the controversies surrounding the definition of remission and reviews the potential of current treatment options to achieve remission. Defining "true" remission can be difficult based on current criteria, which do not consider structural and physical function. Nonetheless, considerable advances in recent years have made the concept of remission a realistic goal. In early RA, substantial and largely irreversible radiographic damage is seen in 60% of patients within the first 2 years of diagnosis. Early therapeutic intervention would ideally lead to reduction in long-term disability in RA and likelihood of inducing and maintaining remission.Long-term maintenance therapy with disease-modifying antirheumatic drugs (DMARDs) has been shown to be effective in preventing flares of disease. Stopping therapy for short periods does not necessarily lead to flares, but the effect on long-term radiographic damage and potential to achieve similar levels of disease control following reinstatement of therapy is not established. Early use of tumour necrosis factor (TNF)-antagonist therapy (e.g. infliximab) has been shown to lead to significant improvement in disease activity measures (clinical and radiologic outcomes) when compared to monotherapy or combination DMARD and corticosteroid therapies. Response was shown to be sustained in 70% of patients receiving TNF-blocking therapy 1 year after stopping treatment. This suggests the significant role of TNF-blocking therapy in enabling sustainable remission without need for long-term administrations, which has important implications for favourable health economics. At present, little published evidence exists on the effects of withdrawal of TNF-blocking therapy in patients with established RA in remission. In conclusion, evidence indicates that remission is a realistic goal, but more evidence is required to establish optimal treatment strategies and define criteria for remission that include imaging and immunological as well as clinical assessment of the disease state.

journal_name

Clin Exp Rheumatol

journal_title

Clinical and experimental rheumatology

authors

Saleem B,Nizam S,Emery P

subject

Has Abstract

pub_date

2006-11-01 00:00:00

pages

S-33-6

issue

6 Suppl 43

eissn

0392-856X

issn

1593-098X

pii

1912

journal_volume

pub_type

杂志文章,评审

在线工具

Can remission be maintained with or without further drug therapy in rheumatoid arthritis?