Comorbidities and extra-articular manifestations in difficult-to-treat rheumatoid arthritis: different sides of the same coin?

被引：29

作者：

Dey, Mrinalini ^{[1
,2
]}

Nagy, Gyorgy ^{[3
,4
,5
]}

Nikiphorou, Elena ^{[6
]}

机构：

[1] Univ Liverpool, Inst Life Course & Med Sci, Brownlow Hill, Liverpool L69 3BX, Merseyside, England

[2] Queen Elizabeth Hosp, Dept Rheumatol, London, England

[3] Semmelweis Univ, Dept Genet Cell & Immunobiol, Budapest, Hungary

[4] Semmelweis Univ, Dept Rheumatol & Clin Immunol, Dept Internal Med & Oncol, Budapest, Hungary

[5] Semmelweis Univ, Heart & Vasc Ctr, Budapest, Hungary

[6] Kings Coll London, Ctr Rheumat Dis, London, England

来源：

RHEUMATOLOGY | 2023年 / 62卷 / 05期

关键词：

comorbidity; multimorbidity; difficult-to-treat; rheumatoid arthritis; disease activity; syndemics; BODY-MASS INDEX; SERIOUS INFECTIONS; DISEASE-ACTIVITY; BRITISH SOCIETY; NECROSIS-FACTOR; DRUG-TREATMENT; LUNG-DISEASE; RISK; PREVALENCE; DEPRESSION;

D O I：

10.1093/rheumatology/keac584

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Despite the improvement in treatment for people with RA, similar to 30% of patients remain symptomatic in the presence of optimized medical therapy, described as having 'difficult-to-treat' (D2T) RA. The average patient with RA has 1.6 other clinical conditions, which accumulate over time. Comorbidities are increasingly recognized as key contributors to D2T disease, and are themselves perpetuated by the D2T state. In this review, we discuss the commonest comorbidities in the context of D2T RA. We propose the need for a paradigm shift in the clinical and research agenda for comorbidities-including a need to consider and manage these prior to the development of D2T disease and not as an afterthought.

引用

页码：1773 / 1779

页数：7

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