Therapie in den Vorstufen der rheumatoiden Arthritis

ZUSAMMENFASSUNG

Durch moderne Therapien und Therapiealgorithmen konnten in der letzten Dekade die Therapieergebnisse in der Behandlung der rheumatoiden Arthritis maßgeblich verbessert werden. Dennoch führt die Erkrankung zu individuellen chronisch-progredienten Einschränkungen und somit auch zu einer sozioökonomischen Belastung. Ein neuer Therapieansatz verspricht hier eine Lösung. Durch Behandlung in Vorstufen der rheumatoiden Arthritis soll die Erkrankung langfristig aufgehalten bis verhindert werden. Diese Übersichtsarbeit fasst aktuelle Erkenntnisse und Studien zusammen und gibt einen Überblick über die medikamentöse Therapie in den Vorstufen der rheumatoiden Arthritis.

Schlüsselwörter

Rheumatoide Arthritis - Therapie - Verlauf - Einschränkungen - Krankheitsaktivität

• Literatur

• 1 Smolen JS, Aletaha D, Barton A. et al Rheumatoid arthritis. Nat Rev Dis Primers 2018; 04: 18001
• 2 Huscher D, Mittendorf T, von Hinuber U, et al, German Collaborative Arthritis C. Evolution of cost structures in rheumatoid arthritis over the past decade. Ann Rheum Dis 2015; 74: 738-745
• 3 Burgers LE, Raza K, van der Helm-van Mil AH. Window of opportunity in rheumatoid arthritis – definitions and supporting evidence: from old to new perspectives. RMD Open 2019; 05: e000870
• 4 van Vollenhoven R. Treat-to-target in rheumatoid arthritis – are we there yet?. Nat Rev Rheumatol 2019; 15: 180-186
• 5 Grigor C, Capell H, Stirling A. et al 2004. Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet 2004; 364: 263-269
• 6 Tascilar KH, Hagen M, Kleyer A. et al Treatment tapering and stopping in patients with rheumatoid arthritis in stable remission (RETRO): a mulitcentre, randomised, controlled, open-label, phase 3 trial. The Lancet Rheumatology 2021; 03: E767-E777
• 7 Greenblatt HK, Kim HA, Bettner LF, Deane KD. Preclinical rheumatoid arthritis and rheumatoid arthritis prevention. Curr Opin Rheumatol 2020; 32: 289-296
• 8 Gerlag DM, Raza K, van Baarsen LG. et al EULAR recommendations for terminology and research in individuals at risk of rheumatoid arthritis: report from the Study Group for Risk Factors for Rheumatoid Arthritis. Ann Rheum Dis 2012; 71: 638-641
• 9 Nielen MM, van Schaardenburg D, Reesink HW. et al Specific autoantibodies precede the symptoms of rheumatoid arthritis: a study of serial measurements in blood donors. Arthritis Rheum 2004; 50: 380-386
• 10 van de Stadt LA, van der Horst AR, de Koning MH. et al The extent of the anti-citrullinated protein antibody repertoire is associated with arthritis development in patients with seropositive arthralgia. Ann Rheum Dis 2011; 70: 128-133
• 11 van Steenbergen HW, Aletaha D, Beaart-van de Voorde LJ. et al EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis. Ann Rheum Dis 2017; 76: 491-496
• 12 Burgers LE, Siljehult F, Ten Brinck RM. et al Validation of the EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis. Rheumatology (Oxford) 2017; 56: 2123-2128
• 13 Rakieh C, Nam JL, Hunt L. et al Predicting the development of clinical arthritis in anti-CCP positive individuals with non-specific musculoskeletal symptoms: a prospective observational cohort study. Ann Rheum Dis 2015; 74: 1659-1666
• 14 Boer AC, Burgers LE, Mangnus L. et al Using a reference when defining an abnormal MRI reduces false-positive MRI results-a longitudinal study in two cohorts at risk for rheumatoid arthritis. Rheumatology (Oxford) 2017; 56: 1700-1706
• 15 Burgers LE, Ten Brinck RM, van der Helm-van Mil AHM. Is joint pain in patients with arthralgia suspicious for progression to rheumatoid arthritis explained by subclinical inflammation? A cross-sectional MRI study. Rheumatology (Oxford) 2019; 58: 86-93
• 16 Tanner S, Dufault B, Smolik I. et al A Prospective Study of the Development of Inflammatory Arthritis in the Family Members of Indigenous North American People With Rheumatoid Arthritis. Arthritis Rheumatol 2019; 71: 1494-1503
• 17 Kelmenson LB, Wagner BD, McNair BK. et al Timing of Elevations of Autoantibody Isotypes Prior to Diagnosis of Rheumatoid Arthritis. Arthritis Rheumatol 2020; 72: 251-261
• 18 Barra L, Bykerk V, Pope JE. et al Anticitrullinated protein antibodies and rheumatoid factor fluctuate in early inflammatory arthritis and do not predict clinical outcomes. J Rheumatol 2013; 40: 1259-1267
• 19 Barra L, Pope J, Bessette L. et al Bykerk V. Lack of seroconversion of rheumatoid factor and anti-cyclic citrullinated peptide in patients with early inflammatory arthritis: a systematic literature review. Rheumatology (Oxford) 2011; 50: 311-316
• 20 McCarey DW, McInnes IB, Madhok R. et al Sattar N. Trial of Atorvastatin in Rheumatoid Arthritis (TARA): double-blind, randomised placebo-controlled trial. Lancet 2004; 363: 2015-2021
• 21 Chodick G, Amital H, Shalem Y. et al Persistence with statins and onset of rheumatoid arthritis: a population-based cohort study. PLoS Med 2010; 07: e1000336
• 22 van Boheemen L, Turk S, Beers-Tas MV. et al Atorvastatin is unlikely to prevent rheumatoid arthritis in high risk individuals: results from the prematurely stopped STAtins to Prevent Rheumatoid Arthritis (STAPRA) trial. RMD Open 2021: 7
• 23 Bos WH, Dijkmans BA, Boers M. et al Effect of dexamethasone on autoantibody levels and arthritis development in patients with arthralgia: a randomised trial. Ann Rheum Dis 2010; 69: 571-574
• 24 Deane K, Striebich C, Feser M. et al Hydroxychloroquine Does Not Prevent the Future Development of Rheumatoid Arthritis in a Population with Baseline High Levels of Antibodies to Citrullinated Protein Antigens and Absence of Inflammatory Arthritis: Interim Analysis of the StopRA Trial [abstract]. Arthritis Rheumatol 2022: 74
• 25 Niemantsverdriet E, Dakkak YJ, Burgers LE. et al TREAT Early Arthralgia to Reverse or Limit Impending Exacerbation to Rheumatoid arthritis (TREAT EARLIER): a randomized, double-blind, placebo-controlled clinical trial protocol. Trials 2020; 21: 862
• 26 Gerlag DM, Safy M, Maijer KI. et al Effects of B-cell directed therapy on the preclinical stage of rheumatoid arthritis: the PRAIRI study. Ann Rheum Dis 2019; 78: 179-185
• 27 Al-Laith M, Jasenecova M, Abraham S. et al Arthritis prevention in the pre-clinical phase of RA with abatacept (the APIPPRA study): a multi-centre, randomised, double-blind, parallel-group, placebo-controlled clinical trial protocol. Trials 2019; 20: 429
• 28 Rech J, Ostergaard M, Tascilar K. et al Abatacept Reverses Subclinical Arthritis in Patients with High-risk to Develop Rheumatoid Arthritis -results from the Randomized, Placebo-controlled ARIAA Study in RA-at Risk Patients [abstract]. Arthritis Rheumatol 2021: 73
• 29 Zaccardelli A, Friedlander HM, Ford JA, Sparks JA. Potential of Lifestyle Changes for Reducing the Risk of Developing Rheumatoid Arthritis: Is an Ounce of Prevention Worth a Pound of Cure?. Clin Ther 2019; 41: 1323-1345