TherapywithDMARDsshouldbestartedassoonasthediagnosisofRAismade.一旦诊断,即应尽快开始DMARDs治疗。
Treatmentshouldbeaimedatreachingatargetofsustainedremmissionorlowdiseaseactivityineverypatient.以持续缓解或低疾病活动度作为目标。
Monitoringshouldbefrequentinactivedisease（every1-3months）；ifthereisnoimprovementbyatmost3monthsafterthestartoftreatmentorthetargethasnotbeenreachedby6months,therapyshouldbeadjusted.密切监测病情（每1-3个月）；调整治疗方案（3个月无改善或6个月不达标）。
MTXshouldbepartofthefirsttreatmentstrategy.MTX作为最初的用药。
InpatientswithacontraindicationtoMTX（orearlyintolerance），leflunomideorsulfasalazineshouldbeconsideredaspartofthe（first）treatmentstrategy.对MTX有禁忌或早期不耐受，可考虑LEF或SASP。
ShorttermglucocorticoidsshouldbeconsideredwheninitiatingorchangingcsDMARDs,indifferentdoseregimentsandroutesofadministration,butshouldbetaperedasrapidlyasclinicallyfeasible.在起始和更换csDMARDs时，可考虑短期糖皮质激素治疗，但应尽快减量。
IfthetreatmenttargetisnotachievedwiththefirstcsDMARDstrategy,intheabsenceofpoorprognosticfactors,otherDMARDsshouldbeconsidered.初始csDMARD治疗疗效不佳时，无预后不良因素，可更换其他DMARDs。
IfthetreatmenttargetisnotachievedwiththefirstcsDMARDstrategy,whenpoorprognosticfactorsarepresent,additionofabDMARDortsDMARDshouldbeconsidered;currentpracticewouldbetostartabDMARD.csDMARD治疗未达标，有预后不良因素，可考虑加用bDMARD和tsDMARD。
bDMARDsandtsDMARDsshouldbe北京有那些中医治白癜风好北京治疗白癜风医院哪个好
转载请注明地址:http://www.shangduxiaofei.com/gjywq/gjywq/116069.html
