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2015年美国风湿病学会类风湿关节炎的治疗指南

2016-04-23 美国风湿病学会 Ann Rheum Dis. 2015 Oct;74(10):1799-807

风湿病

2015年11月6日在美国风湿病年会之际，风湿界权威杂志Arthritis Rheumatol 和Arthritis Care Res（Hoboken）同时发表ACR关于RA 的2015年治疗指南，见表1-3，指南主要针对DMARDs、糖皮质激素、生物制剂、小分子药物的应用和高风险人群应用生物制剂和DMARDs等问题，为RA 患者的治疗提供了全面详细的指导意见。 与2012年的指南相比，

中文标题：

2015年美国风湿病学会类风湿关节炎的治疗指南

英文标题：

2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis

发布机构：

美国风湿病学会

发布日期：

2016-04-23

简要介绍：

2015年11月6日在美国风湿病年会之际，风湿界权威杂志Arthritis Rheumatol 和Arthritis Care Res（Hoboken）同时发表ACR关于RA 的2015年治疗指南，见表1-3，指南主要针对DMARDs、糖皮质激素、生物制剂、小分子药物的应用和高风险人群应用生物制剂和DMARDs等问题，为RA 患者的治疗提供了全面详细的指导意见。

与2012年的指南相比，该版指南采用了国际公认的方法鄄推荐分级的评价、制定与评估系统（GARDE系统），并通过PICO 原则收集更可信的循证医学证据。在总体原则上，专家小组以疾病活动度为选择治疗的主要考虑因素，不再单独考虑预后不良等因素，将治疗费用作为考虑因素之一。

此外，对早期及长病程RA患者的治疗，无论是低疾病活动度还是中/高疾病活动度，均明确推荐首选DMARD（甲氨蝶呤）单药，单药治疗后仍然是中/高疾病活动度的患者， 推荐给予DMARD联合或TNF 抑制剂或非TNF抑制剂（联合或不联合甲氨蝶呤）而不是继续使用DMARDs单药，并强调联合治疗的推荐不分先后；且指南中首次纳入了托法替尼这一新型小分子药物；此外该指南中还规范了相关名词的定义，还将既往有严重感染史纳入高风险因素，并给出相应的推荐意见。

现将该指南中针对早期、长病程及具有高危因素RA患者的治疗推荐意见整理， 以供广大临床工作者参考。

相关资料下载：
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2015年美国风湿病学会类风湿关节炎的治疗指南
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    2020-09-26 ms8000000671774495

    怎么下载？

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=888577, encodeId=d9a98885e72f, content=怎么下载？, beContent=null, objectType=guider, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200926/6fb7d0f5e29d4f14bee472982d5fce95/4880f95c6c5e48e6a2211e67125a6011.jpg, createdBy=e6045421874, createdName=ms8000000671774495, createdTime=Sat Sep 26 18:52:59 CST 2020, time=2020-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370313, encodeId=20113e0313d1, content=没找到哪里可以下载..., beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK8V1W6X5PON4nn3eHD5mF6zHhmwfZw4rGp7DFnpj3hWK9J7Ek1bVMCkGnH0IDiafPA5pNUcakYRWw/132, createdBy=ae422553427, createdName=gray-, createdTime=Fri Jul 26 23:24:00 CST 2019, time=2019-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=366608, encodeId=3dc2366608a4, content=怎么打开啊，又打不开，又下不了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=75e45106561, createdName=146066edm50(暂无昵称), createdTime=Wed May 22 20:10:23 CST 2019, time=2019-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289436, encodeId=66c0289436b5, content=分享到[我的电脑"后可以下载PDF版., beContent=null, objectType=guider, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28a81630482, createdName=qgtan, createdTime=Tue Feb 20 11:45:59 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=287089, encodeId=952228e089e8, content=下不了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73ea2270072, createdName=121a1c71m02暂无昵称, createdTime=Sun Feb 11 13:13:26 CST 2018, time=2018-02-11, status=1, ipAttribution=)]
    2019-07-26 gray-

    没找到哪里可以下载...

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=888577, encodeId=d9a98885e72f, content=怎么下载？, beContent=null, objectType=guider, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200926/6fb7d0f5e29d4f14bee472982d5fce95/4880f95c6c5e48e6a2211e67125a6011.jpg, createdBy=e6045421874, createdName=ms8000000671774495, createdTime=Sat Sep 26 18:52:59 CST 2020, time=2020-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370313, encodeId=20113e0313d1, content=没找到哪里可以下载..., beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK8V1W6X5PON4nn3eHD5mF6zHhmwfZw4rGp7DFnpj3hWK9J7Ek1bVMCkGnH0IDiafPA5pNUcakYRWw/132, createdBy=ae422553427, createdName=gray-, createdTime=Fri Jul 26 23:24:00 CST 2019, time=2019-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=366608, encodeId=3dc2366608a4, content=怎么打开啊，又打不开，又下不了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=75e45106561, createdName=146066edm50(暂无昵称), createdTime=Wed May 22 20:10:23 CST 2019, time=2019-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289436, encodeId=66c0289436b5, content=分享到[我的电脑"后可以下载PDF版., beContent=null, objectType=guider, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28a81630482, createdName=qgtan, createdTime=Tue Feb 20 11:45:59 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=287089, encodeId=952228e089e8, content=下不了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73ea2270072, createdName=121a1c71m02暂无昵称, createdTime=Sun Feb 11 13:13:26 CST 2018, time=2018-02-11, status=1, ipAttribution=)]
    2019-05-22 146066edm50(暂无昵称)

    怎么打开啊，又打不开，又下不了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=888577, encodeId=d9a98885e72f, content=怎么下载？, beContent=null, objectType=guider, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200926/6fb7d0f5e29d4f14bee472982d5fce95/4880f95c6c5e48e6a2211e67125a6011.jpg, createdBy=e6045421874, createdName=ms8000000671774495, createdTime=Sat Sep 26 18:52:59 CST 2020, time=2020-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370313, encodeId=20113e0313d1, content=没找到哪里可以下载..., beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK8V1W6X5PON4nn3eHD5mF6zHhmwfZw4rGp7DFnpj3hWK9J7Ek1bVMCkGnH0IDiafPA5pNUcakYRWw/132, createdBy=ae422553427, createdName=gray-, createdTime=Fri Jul 26 23:24:00 CST 2019, time=2019-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=366608, encodeId=3dc2366608a4, content=怎么打开啊，又打不开，又下不了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=75e45106561, createdName=146066edm50(暂无昵称), createdTime=Wed May 22 20:10:23 CST 2019, time=2019-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289436, encodeId=66c0289436b5, content=分享到[我的电脑"后可以下载PDF版., beContent=null, objectType=guider, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28a81630482, createdName=qgtan, createdTime=Tue Feb 20 11:45:59 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=287089, encodeId=952228e089e8, content=下不了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73ea2270072, createdName=121a1c71m02暂无昵称, createdTime=Sun Feb 11 13:13:26 CST 2018, time=2018-02-11, status=1, ipAttribution=)]
    2018-02-20 qgtan

    分享到[我的电脑"后可以下载PDF版.

    0

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    2018-02-11 121a1c71m02暂无昵称

    下不了

    0

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