类风湿关节炎治疗的进展与挑战

Progresses and Challenges in the Treatment of Rheumatoid Arthritis

类风湿关节炎(rheumatoid arthritis, RA)是一种慢性、全身性、异常的炎性免疫反应。其特点是累及滑膜和多器官,并造成关节和关节软骨破坏。在过去的30年里,一些有希望的新化合物和抗体已经被开发出来用于治疗RA。而RA治疗药物的引入和精准医学的发展也引发了与患者获得新疗法、最佳方案选择、成本效益、预后监测和疗效监测相关的几个问题,特别是在药物反应率低、耐药性和不良副作用方面。人们非常重视治疗RA的最佳药物组合,特别是在症状严重或早期进展的患者中。解决这些问题需要新的治疗方法和新的机制,并为药物选择、药物重组建立准确的指南。笔者根据美国国家医学图书馆的临床试验数据库,综述了有前景的新药,并讨论了RA药物开发的趋势和治疗中的挑战,为RA的精准治疗和未来的研究方向提供了参考。

Rheumatoid arthritis(RA)is a chronic,systemic,and abnormal inflammatory immune response.It is characterized by the involvement of synovium and multiple organs and the destruction of joints and articular cartilage.In the past 30 years,some promising new compounds and antibodies have been developed to treat RA.The introduction of RA therapeutic drugs and the development of precision medicine have also given rise to several problems related to patients′access to new treatments,choice of the best regimen,cost-effectiveness,prognosis monitoring and efficacy monitoring,especially in terms of low drug response rate,drug resistance and adverse side effects.People attach great importance to the best combination of drugs for the treatment of RA,especially in patients with severe symptoms or early progression.New treatments and mechanisms are needed to solve these problems,and accurate guidelines for drug selection and drug recombination are established.According to the clinical trial database of the National Library of Medicine,this study summarizes the exciting new drugs,and discusses the trends and challenges in the development of RA drugs,which provides a meaningful reference for the accurate treatment and future research direction of RA.