Pregledni rad

Clinical approach to a patient with rheumatoid arthritis

Dijana Perković ; Klinički odjel za reumatologiju i imunologiju, Klinika za unutarnje bolesti, Klinički bolnički centar Split, Split, Hrvatska
Dušanka Martinović Kaliterna ; Klinički odjel za reumatologiju i imunologiju, Klinika za unutarnje bolesti, Klinički bolnički centar Split, Split, Hrvatska
Daniela Marasović Krstulović ; Klinički odjel za reumatologiju i imunologiju, Klinika za unutarnje bolesti, Klinički bolnički centar Split, Split, Hrvatska
Ivona Božić ; Klinički odjel za reumatologiju i imunologiju, Klinika za unutarnje bolesti, Klinički bolnički centar Split, Split, Hrvatska
Katarina Borić ; Klinički odjel za reumatologiju i imunologiju, Klinika za unutarnje bolesti, Klinički bolnički centar Split, Split, Hrvatska
Mislav Radić ; Klinički odjel za reumatologiju i imunologiju, Klinika za unutarnje bolesti, Klinički bolnički centar Split, Split, Hrvatska

Sažetak

Rheumatoid arthritis (RA) is chronic inflammatory rheumatic disease which leads to joint damage, functional impairment and reduced quality of life. The disease should be recognized early when there is a “window of opportunity” to apply adequate treatment which may prevent structural damage. As clinical presentation of RA is not always typical, great knowledge and clinical experience, including collaboration of rheumatologist, general practitioner and patient, are required. The treatment should be started immediately upon the diagnosis, while the choice of modality of treatment depends on the rheumatologist in accordance with the patient. The RA patients with the higher risk of aggressive disease need to be recognized because they require more aggressive treatment from the start. The goal of the treatment is remission or at least low disease activity. Current treatment of RA includes disease modifying antirheumatic drugs (DMARDs) synthetics and biologics, nonsteroidal antirheumatic drugs (NSAIDs), glucocorticoids, analgesics, and rarely cytostatics. The course of disease is usually fluctuating with the exchange of relapses and remissions. Recognition of the relapsing patient on time enables treatment intensification or modifications in treatment scheme. Special issue in RA represents glucocorticoid-induced osteoporosis (GIO) which should be prevented by usage of calcium and vitamin D supplements and treated by antiresorptive or osteoanabolic agents. Besides the treatment of the primary disease, the care of RA patients should consider comorbidities, side effects of treatment, complications of disease, and psychosocial aspects of chronic disease.

Ključne riječi

rheumatoid arthritis; clinical approach; early diagnosis; multidisciplinary care

Hrčak ID:

137893

URI

https://hrcak.srce.hr/137893

Datum izdavanja:

23.10.2014.

Podaci na drugim jezicima: hrvatski

Posjeta: 8.623 *