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Aliment Pharmacol Ther:走向克罗恩氏病和类风湿关节炎的共同治疗目标

2017-05-13 应颖秋;常路 环球医学

克罗恩氏病(CD)和类风湿关节炎是慢性的进展性和致残性疾病,常可造成结构组织损伤。基于原先开发的类风湿关节炎的策略,最近,CD的治疗目标已经从完全控制症状转移到临床缓解和完全黏膜愈合(深度缓解),最终的目的为防止肠道损伤和残疾。2017年4月,发表在《Aliment Pharmacol Ther》的一项综述回顾CD和类风湿关节炎治疗目的的相似性和差异。

克罗恩氏病(CD)和类风湿关节炎是慢性的进展性和致残性疾病,常可造成结构组织损伤。基于原先开发的类风湿关节炎的策略,最近,CD的治疗目标已经从完全控制症状转移到临床缓解和完全黏膜愈合(深度缓解),最终的目的为防止肠道损伤和残疾。2017年4月,发表在《Aliment Pharmacol Ther》的一项综述回顾CD和类风湿关节炎治疗目的的相似性和差异。

目的:旨在回顾CD和类风湿关节炎治疗目的的相似性和差异。

方法:本综述检测了1982~2016年发表的文献,这些文献都依据各自的支持性证据讨论和提出了CD和类风湿关节炎的治疗目标。

结果:提出的改善类风湿关节炎和CD结局的治疗策略包括:(1)肌肉骨骼或器官损伤和残疾的评估;(2)严格控制;(3)治疗目标;(4)早期干预;(5)疾病修正。与类风湿关节炎相反,CD的疾病修正试验存在不足。

结论:基于炎症客观体征的严格控制,CD的新治疗策略有望通过阻止进展或理论上阻止肠道损伤复发而改变病程和患者的生命。这些策略的多数需要在前瞻性研究中予以验证,而过去十年的一些疾病修正试验已经在类风湿关节炎中解决了这些问题。最近获准的CD新药如维多珠单抗和优斯它单抗将在不久的将来促进CD的疾病修饰试验的开始。

原始出处:

Allen PB, Olivera P, et al. Review article: moving towards common therapeutic goals in Crohn's disease and rheumatoid arthritis. Aliment Pharmacol Ther. 2017 Apr;45(8):1058-1072. doi: 10.1111/apt.13995. 

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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Mon Jun 12 22:36:06 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203121, encodeId=2d93203121ab, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sat May 27 07:34:28 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202557, encodeId=1d7f20255e3e, content=学习了,多谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Thu May 25 23:34:21 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200906, encodeId=f73e200906a1, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Sun May 21 15:43:56 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200402, encodeId=25b120040271, content=学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sat May 20 12:15:34 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1787249, encodeId=a4d31e87249dc, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Mon Jan 08 16:37:00 CST 2018, time=2018-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003482, encodeId=ffb62003482dd, content=<a href='/topic/show?id=5b592889555' target=_blank style='color:#2F92EE;'>#克罗恩氏病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28895, encryptionId=5b592889555, topicName=克罗恩氏病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=139a316, createdName=wumeihua88, createdTime=Mon Sep 11 11:37:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908255, encodeId=bb9c19082557b, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Mon Oct 09 15:37:00 CST 2017, time=2017-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788217, encodeId=d7231e8821753, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Oct 27 16:37:00 CST 2017, time=2017-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995982, encodeId=8005199598280, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Fri Oct 27 21:37:00 CST 2017, time=2017-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209942, encodeId=434e20994255, content=学习了,长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Mon Jun 12 22:36:06 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203121, encodeId=2d93203121ab, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sat May 27 07:34:28 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202557, encodeId=1d7f20255e3e, content=学习了,多谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Thu May 25 23:34:21 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200906, encodeId=f73e200906a1, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Sun May 21 15:43:56 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200402, encodeId=25b120040271, content=学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sat May 20 12:15:34 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-10-27 yb6560
  6. [GetPortalCommentsPageByObjectIdResponse(id=1787249, encodeId=a4d31e87249dc, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Mon Jan 08 16:37:00 CST 2018, time=2018-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003482, encodeId=ffb62003482dd, content=<a href='/topic/show?id=5b592889555' target=_blank style='color:#2F92EE;'>#克罗恩氏病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28895, encryptionId=5b592889555, topicName=克罗恩氏病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=139a316, 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Mon Jun 12 22:36:06 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203121, encodeId=2d93203121ab, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sat May 27 07:34:28 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202557, encodeId=1d7f20255e3e, content=学习了,多谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Thu May 25 23:34:21 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200906, encodeId=f73e200906a1, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Sun May 21 15:43:56 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200402, encodeId=25b120040271, content=学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sat May 20 12:15:34 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-06-12 1e1263e3m20(暂无匿称)

    学习了,长见识了

    0

  7. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Mon Jun 12 22:36:06 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203121, encodeId=2d93203121ab, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sat May 27 07:34:28 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202557, encodeId=1d7f20255e3e, content=学习了,多谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Thu May 25 23:34:21 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200906, encodeId=f73e200906a1, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Sun May 21 15:43:56 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200402, encodeId=25b120040271, content=学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sat May 20 12:15:34 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-05-27 lofter

    学习了,感谢分享!

    0

  8. 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encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Oct 27 16:37:00 CST 2017, time=2017-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995982, encodeId=8005199598280, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Fri Oct 27 21:37:00 CST 2017, time=2017-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209942, encodeId=434e20994255, content=学习了,长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Mon Jun 12 22:36:06 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203121, encodeId=2d93203121ab, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sat May 27 07:34:28 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202557, encodeId=1d7f20255e3e, content=学习了,多谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Thu May 25 23:34:21 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200906, encodeId=f73e200906a1, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Sun May 21 15:43:56 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200402, encodeId=25b120040271, content=学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sat May 20 12:15:34 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-05-25 1e1263e3m20(暂无匿称)

    学习了,多谢分享

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1787249, encodeId=a4d31e87249dc, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Mon Jan 08 16:37:00 CST 2018, time=2018-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003482, encodeId=ffb62003482dd, content=<a href='/topic/show?id=5b592889555' target=_blank style='color:#2F92EE;'>#克罗恩氏病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28895, encryptionId=5b592889555, topicName=克罗恩氏病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=139a316, 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Mon Jun 12 22:36:06 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203121, encodeId=2d93203121ab, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sat May 27 07:34:28 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202557, encodeId=1d7f20255e3e, content=学习了,多谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Thu May 25 23:34:21 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200906, encodeId=f73e200906a1, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Sun May 21 15:43:56 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200402, encodeId=25b120040271, content=学习一下知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sat May 20 12:15:34 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-05-21 cuiyejia

    学习了,谢谢

    0

  10. 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2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-05-20 flysky120

    学习一下知识

    0

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