Evidence for treating rheumatoid arthritis to target: results of a systematic literature search

被引：197

作者：

Schoels, Monika ^{[1
]}

Knevel, Rachel ^{[2
]}

Aletaha, Daniel ^{[3
]}

Bijlsma, Johannes W. J. ^{[4
]}

Breedveld, Ferdinand C. ^{[2
]}

Boumpas, Dimitrios T. ^{[5
]}

Burmester, Gerd ^{[6
]}

Combe, Bernard ^{[7
]}

Cutolo, Maurizio ^{[8
,9
]}

Dougados, Maxime ^{[10
]}

Emery, Paul ^{[11
]}

van der Heijde, Desiree ^{[2
]}

Huizinga, Tom W. J. ^{[2
]}

Kalden, Joachim ^{[12
]}

Keystone, Edward C. ^{[13
]}

Kvien, Tore K. ^{[14
]}

Martin-Mola, Emilio ^{[15
]}

Montecucco, Carlomaurizio ^{[16
]}

De Wit, Maarten ^{[17
]}

Smolen, Josef S. ^{[1
,3
]}

机构：

[1] Hietzing Hosp, Ctr Rheumat Dis, Dept Internal Med 2, Vienna, Austria

[2] Leiden Univ, Med Ctr, Dept Rheumatol, Leiden, Netherlands

[3] Med Univ Vienna, Dept Internal Med 3, Div Rheumatol, A-1090 Vienna, Austria

[4] Univ Med Ctr Utrecht, Dept Rheumatol & Clin Immunol, Utrecht, Netherlands

[5] Univ Crete, Sch Med, Dept Internal Med, Iraklion, Greece

[6] Humboldt Univ, Charite Hosp, Dept Rheumatol & Clin Immunol, Berlin, Germany

[7] Univ Montpellier, Lapeyronie Hosp, Serv Immunorhumatol, F-34059 Montpellier, France

[8] Univ Genoa, Dept Internal Med, Res Lab, Genoa, Italy

[9] Univ Genoa, Dept Internal Med, Acad Clin Unit Rheumatol, Genoa, Italy

[10] Univ Paris 05, Cochin Hosp, Dept Rheumatol B, Paris, France

[11] Univ Leeds, Acad Unit Musculoskeletal Dis, Leeds, W Yorkshire, England

[12] Univ Erlangen Nurnberg, Inst Clin Immunol, Dept Internal Med 3, Erlangen, Germany

[13] Mt Sinai Hosp, Rebecca MacDonald Ctr Arthrit & Autoimmune Dis, Toronto, ON M5G 1X5, Canada

[14] Diakonhjemmet Hosp, Dept Rheumatol, Oslo, Norway

[15] Hosp La Paz, Madrid, Spain

[16] Univ Pavia, Policlin San Matteo, IRCCS, Dept Rheumatol, I-27100 Pavia, Italy

[17] EULAR Standing Comm People Arthrit Rheumatism Eur, Zurich, Switzerland

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2010年 / 69卷 / 04期

关键词：

DISEASE-ACTIVITY; TIGHT CONTROL; RADIOLOGIC DAMAGE; BLOOD-PRESSURE; MANAGEMENT; METHOTREXATE; COMBINATION; PROGRESSION; REMISSION; HYPERTENSION;

D O I：

10.1136/ard.2009.123976

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives To summarise existing evidence on a target oriented approach for rheumatoid arthritis (RA) treatment. Methods We conducted a systematic literature search including all clinical trials testing clinical, functional, or structural values of a targeted treatment approach. Our search covered Medline, Embase and Cochrane databases until December 2008 and also conference abstracts (2007, 2008). Results The primary search yielded 5881 citations; after the selection process, 76 papers underwent detailed review. Of these, only seven strategic clinical trials were extracted: four studies randomised patients to routine or targeted treatment, two compared two different randomised targets and one compared targeted treatment to a historical control group. Five trials dealt with early RA patients. All identified studies showed significantly better clinical outcomes of targeted approaches than routine approaches. Disability was reported in two studies with no difference between groups. Four studies compared radiographic outcomes, two showing significant benefit of the targeted approach. Conclusion Only few studies employed randomised controlled settings to test the value of treatment to a specific target. However, they provided unanimous evidence for benefits of targeted approaches. Nevertheless, more data on radiographic and functional outcomes and on patients with established RA are needed.

引用

页码：638 / 643

页数：6

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