Drug Therapy for Rheumatoid Arthritis in Adults: An Update. Executive Summary. Comparative Effectiveness Review Number 55.

摘要

Rheumatoid arthritis (RA), which affects 1.3 million adult Americans, is an autoimmune disease that involves inflammation of the synovium (a thin layer of tissue lining a joint space) with progressive erosion of bone leading in most cases to misalignment of the joint, loss of function, and disability. The disease tends to affect the small joints of the hands and feet in a symmetric pattern, but other joint patterns are often seen. The diagnosis is based primarily on the clinical history and physical examination with support from selected laboratory tests. Treatment of patients with RA aims to control pain and inflammation and, ultimately, the goal is remission or at least low disease activity for all patients. Available therapies for RA include corticosteroids, oral disease-modifying antirheumatic drugs or DMARDs (hydroxychloroquine, leflunomide, methotrexate (MTX), and sulfasalazine), and biologic DMARDs (five anti-tumor necrosis factor drugs (anti-TNF): adalimumab, certolizumab, etanercept, golimumab, infliximab; and others including abatacept, anakinra, rituximab, and tocilizumab).