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Frühe und fortgeschrittene rheumatoide Arthritis

Diagnostik und aktuelle Behandlungsstrategie

Early and advanced rheumatoid arthritis

Diagnosis and state of the art therapy strategy

Zeitschrift für Rheumatologie volume 71, pages 53–63 (2012)Cite this article

Zusammenfassung

Für die Diagnose einer rheumatoiden Arthritis (RA) werden oft Klassifikationskriterien herangezogen. 2010 wurden die neuen ACR/EULAR-Klassifikationskriterien für die RA vorgestellt, die eine frühzeitigere Erfassung von Patienten erlauben, die ein hohes Risiko für eine chronisch-persistierende, erosiv verlaufende Arthritis aufweisen und damit der Definition einer RA entsprechen. Die Therapie mit krankheitsmodifizierenden Medikamenten sollte möglichst frühzeitig einsetzen. Methotrexat gilt als Standardtherapeutikum der ersten Wahl. Bei unzureichendem Ansprechen ist die Effektivität einer Biologikatherapie belegt. Für die Behandlung entscheidend ist die Definition des Therapieziels – in Frühfällen Remission, in späteren Stadien eine möglichst niedrige Krankheitsaktivität. Das Erreichen dieses Therapieziels sollte regelmäßig geprüft und die medikamentöse Therapie entsprechend angepasst werden.

Abstract

The diagnosis of rheumatoid arthritis (RA) is often based on classification criteria. In 2010 ACR and EULAR presented new classification criteria for RA which allow patients with a high risk for persistent, chronic and erosive arthritis and therefore fulfill the current definition of RA, to be defined. Therapy of RA should be initiated as early as possible. Methotrexate remains the first-line therapy of RA. In patients showing insufficient response of RA, biological agents have been demonstrated to be an effective second-line therapy. It is essential to define and follow an individual treatment target to obtain remission or low disease activity. This target should be reassessed regularly and treatment should be correspondingly adapted to achieve the target.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Forschungsprojekte, Beratung und Vorträge für die Firmen Abbott, Amgen, AstraZeneca, BMS, Chugai, GlaxoSmithKline, Medac, MSD, Novartis, Pfizer, Roche, Sanofi-Aventis, UCB (J.W.); Vorträge und Beratungstätigkeit für die Firmen Abbott, Bristol Myers Squibb, Medac, MSD, Pfizer, Roche, UCB (K.K.).

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Affiliations

  1. Klinik für Rheumatologie und klinische Immunologie und Rheumatologikum, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Deutschland

    J. Wollenhaupt

  2. Rheumatologisches Zentrum St. Bonifatius, München, Deutschland

    K. Krüger

Authors
  1. J. Wollenhaupt
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  2. K. Krüger
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Correspondence to J. Wollenhaupt.

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Wollenhaupt, J., Krüger, K. Frühe und fortgeschrittene rheumatoide Arthritis. Z. Rheumatol. 71, 53–63 (2012). https://doi.org/10.1007/s00393-011-0932-1

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  • DOI: https://doi.org/10.1007/s00393-011-0932-1

Schlüsselwörter

  • Rheumatoide Arthritis
  • Klassifikationskriterien
  • Therapiestrategie
  • DMARD
  • Biologika

Keywords

  • Rheumatoid arthritis
  • Classification criteria
  • Therapeutic strategy
  • DMARD
  • Biologicals