炎症性肠病并发关节炎--未来就在眼前。

IF 15 1区 医学 Q1 RHEUMATOLOGY Lancet Rheumatology Pub Date : 2024-07-17 DOI:10.1016/S2665-9913(24)00132-2
Kaiyang Song BM BCh , Prof Jack Satsangi DPhil , Laura C Coates PhD
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引用次数: 0

摘要

免疫介导的炎症性疾病正在取得根本性进展。最近的治疗进展包括预防高危人群类风湿性关节炎的策略、使用基线细胞免疫表型预测银屑病关节炎患者对生物制剂的反应,以及使用生物制剂自上而下治疗克罗恩病。然而,在脊柱关节病并发炎症性肠病(IBD)患者的治疗方面却没有取得有意义的进展。目前,人们对 IBD 相关脊柱关节病的病理生理学知之甚少;此外,也没有公认的或针对特定疾病的筛查工具、诊断标准或许可治疗方法。尽管越来越多的人认识到 IBD 相关脊柱关节病是一个独立的实体,具有独特的表型,但风湿病学家和胃肠病学家目前的临床治疗方法在很大程度上分别涉及脊柱关节病和 IBD 临床指南的推断。IBD并发脊柱关节病与银屑病并发关节病的治疗形成了明显的对比,在银屑病领域,明确的诊断标准和专门的临床试验为明确的治疗提供了指导。我们认为,现在已经到了采用并行方法和专门关注 IBD 相关脊柱关节病的时候了。
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Arthritis complicating inflammatory bowel disease— the future is now
Fundamental advances are occurring across immune-mediated inflammatory diseases. Recent therapeutic developments include strategies to prevent rheumatoid arthritis in high-risk individuals, using baseline cellular immunophenotypes to predict response to biologics in psoriatic arthritis, and using biologics in a top-down approach for Crohn's disease. However, meaningful progress has not occurred in the management of patients with spondyloarthropathy complicating inflammatory bowel disease (IBD). Currently, the pathophysiology of IBD-related spondyloarthropathy is poorly understood; moreover, there are no accepted or disease-specific screening tools, diagnostic criteria, or licenced treatments. Current approaches to clinical care from rheumatologists and gastroenterologists largely involve the extrapolation of spondyloarthropathy and IBD clinical guidelines, respectively, despite increasing recognition of IBD-related spondyloarthropathy being its own entity, with a unique phenotype. There is an obvious contrast between spondyloarthropathy complicating IBD and the management of arthropathy complicating psoriasis, a disease area where defined diagnostic criteria and dedicated clinical trials allow clear management guidelines. We argue that the time has come for a parallel approach and dedicated focus on IBD-related spondyloarthropathy.
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来源期刊
Lancet Rheumatology
Lancet Rheumatology RHEUMATOLOGY-
CiteScore
34.70
自引率
3.10%
发文量
279
期刊介绍: The Lancet Rheumatology, an independent journal, is dedicated to publishing content relevant to rheumatology specialists worldwide. It focuses on studies that advance clinical practice, challenge existing norms, and advocate for changes in health policy. The journal covers clinical research, particularly clinical trials, expert reviews, and thought-provoking commentary on the diagnosis, classification, management, and prevention of rheumatic diseases, including arthritis, musculoskeletal disorders, connective tissue diseases, and immune system disorders. Additionally, it publishes high-quality translational studies supported by robust clinical data, prioritizing those that identify potential new therapeutic targets, advance precision medicine efforts, or directly contribute to future clinical trials. With its strong clinical orientation, The Lancet Rheumatology serves as an independent voice for the rheumatology community, advocating strongly for the enhancement of patients' lives affected by rheumatic diseases worldwide.
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