Risikostratifizierung für Therapieentscheidungen bei Rheumatoider Arthritis

Zusammenfassung

Um für die Behandlung der rheumatoiden Arthritis unter der Vielzahl an zugelassenen krankheitsmodifizierenden Antirheumatika die geeignete Therapie auszuwählen, werden Patienten anhand ihres Risikos für einen ungünstigen Krankheitsverlauf stratifiziert. Die Auswahl geeigneter Parameter zur Risikostratifizierung werden in dieser Übersichtsarbeit dargestellt. Beim heutigen Therapieziel einer Remission sind hohe Krankheitsaktivität, Funktionseinschränkungen, Begleiterkrankungen und Übergewicht relevante Faktoren für einen ungünstigen Verlauf. Weitere Einflussfaktoren auf die Therapieentscheidung wie Begleiterkrankungen, Infektionsrisiko und spezielle Risikokonstellationen wie vorausgegangene schwerwiegende Infektionen oder Malignome werden in diesem Artikel diskutiert.

Abstract

In order to select the appropriate drug for the treatment of rheumatoid arthritis, patients are stratified according to their risk of an unfavourable course. This review paper presents the selection of suitable parameters for risk stratification. In the light of the current therapeutic target of remission, relevant factors for an unfavourable course include high disease activity, functional limitations and the presence of comorbidities and obesity. Also this article discusses further factors influencing treatment decisions, e. g. concomitant diseases, risk of infection and special risk constellations such as previous serious infections or malignancies.

Schlüsselwörter

DMARDs - biologics - disease activity - infections - comorbidity

Key words

DMARDs - Biologika - Krankheitsaktivität - Infektionen - Komorbidität

Publication History

Article published online:
09 February 2021

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