Arthritis und Rheuma 2014; 34(01): 9-14
DOI: 10.1055/s-0037-1617969
Rheumatische Erkrankungen mit schwerem Verlauf
Schattauer GmbH

Welche Parameter beeinflussen die Prognose der rheumatoiden Arthritis?

Which parameters show an impact on the prognosis of rheumatoid arthritis?
H. Becker
1   Universitätsklinikum Münster, Innere Medizin D/Sektion Rheumatologie und Klinische Immunologie
,
P. Willeke
1   Universitätsklinikum Münster, Innere Medizin D/Sektion Rheumatologie und Klinische Immunologie
,
A. M. Jacobi
1   Universitätsklinikum Münster, Innere Medizin D/Sektion Rheumatologie und Klinische Immunologie
› Author Affiliations
Further Information

Publication History

Publication Date:
26 December 2017 (online)

Zusammenfassung

Die rheumatoide Arthritis ist eine häufige entzündlich rheumatische Erkrankung mit artikulären und extraartikulären Manifestationen. Die Prognose der Erkrankung wird bestimmt durch die Aktivität der Erkrankung unter Berücksichtigung des Ansprechens auf die Therapie. Parameter wie der DAS28, der HAQ, das CRP, die BSG, serologische Befunde, bereits vorhandene Erosionen, Alter bei der Erstmanifestation und Geschlecht der Patienten zeigen einen Einfluss auf das Outcome. Diese Risikofaktoren sollten bei Diagnosestellung evaluiert werden. Nach ca. drei bis sechs Monaten sollten die klinischen Parameter und Laborparameter zur Abschätzung der Prognose erneut erfasst werden. Aber auch extraartikuläre Manifestationen und Komorbiditäten sollten berücksichtigt werden, denn sie haben ebenfalls einen Einfluss auf die Prognose und vor allem auf die Mortalität der Erkrankung und sind eine häufige Ursache für ein suboptimales Ergebnis bezüglich der antirheumatischen Langzeittherapie und der Therapieadhärenz.

Summary

Rheumatoid arthritis is a common inflammatory joint-disease going along with extraarticular manifestations. Prognosis is determined by the disease activity and response to treatment. Various parameters, such as DAS28, HAQ, CRP, ESR, serology, erosions, age at the time of diagnosis and gender influence the outcome. These risk factors should be evaluated when diagnosis is confirmed. After 3 to 6 months, clinical and laboratory measures should be assessed again to evaluate prognosis. But also extra-articular manifestations and co-morbidities should be considered since they show an impact on prognosis and mortality and are often responsible for suboptimal therapeutic results and lack of adherence.

 
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