{"title":"Highlights of advancement in Rheumatoid Arthritis research and clinical practice.","authors":"Jing He, Ajesh Basantharan Maharaj","doi":"10.1016/j.berh.2025.102040","DOIUrl":null,"url":null,"abstract":"<p><p>The management of RA has evolved with the advent of targeted therapies and international treatment guidelines. In \"Global RA Treatment Recommendations,\" Maharaj and colleagues compare protocols from leading organizations, including ACR (American College of Rheumatology), EULAR (European Alliance of Associations for Rheumatology), and APLAR (Asia Pacific Leagues of Associations for Rheumatology) They analyze regional differences in the use of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biologic disease-modifying antirheumatic drugs (bDMARDs), and Janus kinase (JAK) inhibitors, emphasizing the role of shared decision-making in addressing healthcare disparities.However, for patients with severe joint damage or advanced disease unresponsive to pharmacologic treatments, surgical approaches remain a critical component of care. In \"Joint Replacement for Rheumatoid Arthritis,\" Lü and colleagues explore indications for joint replacement surgery techniques and outcomes, particularly in addressing pain relief, functional restoration, and quality of life. The article highlights advancements in surgical technology and perioperative management that have improved patient outcomes while reducing complication rates.Building on the theme of personalised care, He and colleagues discuss the Treat-to-Target (T2T) approach in \"Theory & Practice of Treat-to-Target in RA.\" This strategy prioritises achieving remission or low disease activity through continuous monitoring and individualised treatment adjustments. The article highlights the importance of biological therapies and rigorous assessment tools, presenting T2T as a cornerstone of effective RA management. These pharmacologic, surgical, and personalised approaches form a comprehensive framework for managing RA across its clinical spectrum.Achieving deep remission remains a primary goal in RA therapy. In \"Promise of RA Therapy: From Deep Remission to Drug-Free,\" Li Z. and colleagues discuss the feasibility of discontinuing medication in patients who achieve sustained remission. The article also evaluates advanced imaging techniques, such as ultrasound and MRI, to monitor disease activity and guide treatment decisions.</p>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102040"},"PeriodicalIF":4.5000,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Best Practice & Research in Clinical Rheumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.berh.2025.102040","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
The management of RA has evolved with the advent of targeted therapies and international treatment guidelines. In "Global RA Treatment Recommendations," Maharaj and colleagues compare protocols from leading organizations, including ACR (American College of Rheumatology), EULAR (European Alliance of Associations for Rheumatology), and APLAR (Asia Pacific Leagues of Associations for Rheumatology) They analyze regional differences in the use of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biologic disease-modifying antirheumatic drugs (bDMARDs), and Janus kinase (JAK) inhibitors, emphasizing the role of shared decision-making in addressing healthcare disparities.However, for patients with severe joint damage or advanced disease unresponsive to pharmacologic treatments, surgical approaches remain a critical component of care. In "Joint Replacement for Rheumatoid Arthritis," Lü and colleagues explore indications for joint replacement surgery techniques and outcomes, particularly in addressing pain relief, functional restoration, and quality of life. The article highlights advancements in surgical technology and perioperative management that have improved patient outcomes while reducing complication rates.Building on the theme of personalised care, He and colleagues discuss the Treat-to-Target (T2T) approach in "Theory & Practice of Treat-to-Target in RA." This strategy prioritises achieving remission or low disease activity through continuous monitoring and individualised treatment adjustments. The article highlights the importance of biological therapies and rigorous assessment tools, presenting T2T as a cornerstone of effective RA management. These pharmacologic, surgical, and personalised approaches form a comprehensive framework for managing RA across its clinical spectrum.Achieving deep remission remains a primary goal in RA therapy. In "Promise of RA Therapy: From Deep Remission to Drug-Free," Li Z. and colleagues discuss the feasibility of discontinuing medication in patients who achieve sustained remission. The article also evaluates advanced imaging techniques, such as ultrasound and MRI, to monitor disease activity and guide treatment decisions.
期刊介绍:
Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions.
Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science.
The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update.
Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.