ABSTRACT

Introduction: The cornerstone of rheumatoid arthritis (RA) therapy relies on the treat-to-target strategy, which aims at dampening inflammation as soon as possible in order to achieve persistent low disease activity or, ideally, remission, according to validated disease activity measures. Traditional disease-modifying antirheumatic drugs (DMARDs) may be chosen in monotherapy or in combination as first-line therapy; in case of an unsatisfactory response after a 3-6-month trial, biologic therapy may be commenced.

Areas covered: Real-life RA patients may present with concomitant comorbidities/complications or be in peculiar physiological states which raise more than one question as to which biotherapy may be more well suited considering the whole clinical picture. Therefore, a thorough literature search was performed to identify the most appropriate biologic therapy in each setting considered in this review.

Expert opinion: Here we provide suggestions for the use of biologic drugs having a predictable better outcome in specific real-world conditions, so as to ideally profile the patient to the best of the current knowledge.

摘要

简介: 类风湿性关节炎 (RA) 治疗的基石依赖于靶向治疗策略，该策略旨在尽快抑制炎症，以实现持续的低疾病活动度，或者根据经过验证的疾病活动度指标，理想情况下达到缓解. 传统的缓解疾病的抗风湿药（DMARDs）可选择单药或联合作为一线治疗；如果在 3-6 个月的试验后反应不令人满意，可以开始生物治疗。

涵盖的领域：现实生活中的 RA 患者可能会出现伴随的合并症/并发症或处于特殊的生理状态，这就提出了一个以上的问题，即考虑到整个临床情况，哪种生物疗法可能更适合。因此，进行了彻底的文献检索，以确定在本综述中考虑的每种情况下最合适的生物疗法。

专家意见：在这里，我们提供了在特定现实世界条件下使用具有可预测的更好结果的生物药物的建议，以便根据当前知识的最佳情况对患者进行理想的分析。