Romatoid Artrit İçin Birinci Basamak Kullanımına Yönelik Kanıta Dayalı Bir Rehber Çalışması

Romatoid Artrit (RA); dünyada en sık (popülasyonun yaklaşık % 1’i) görülen inflamatuar artrittir. Orta yaşlarda daha çok kadınlarda görülürken (2:1), yaş ilerledikçe bu oran 1:1’e yakın olur. Kadınlarda en sık 50-55 yaşlarında arasında, erkeklerde ise daha geç yaşlarda görülür. RA tedavisine güncel yaklaşım, erken ve agresiftir. Tedavi edilmez veya tedavi başlanmasında gecikme olması durumunda 10 yıl içinde pek çok hastada kalıcı deformiteler gelişir. Aile hekimi, 50-55 yaşlarında özellikle bayan hastalarda, ellerde ve ayaklarda küçük eklemlerde simetrik ağrı ve şişlik, sabahları eklemlerde 30 dakikadan fazla süren tutukluk saptaması halinde, gecikmeksizin Romatoloji/ FTR uzmanına sevk etmelidir.

Anahtar Kelimeler:

Romatid artrit, Birinci basamak, popülasyon

An Evidence Based Guideline For Rheumatoid Arthritis For Primary Care

Rheumatoid arthritis (RA), is the most commonly(in about %1 of the population) observed inflammatory arthritis.Being observed more in women during middle ages (the ratio 2:1), this ratio gets closer to 1:1 while age gets higher. The illness is observed mostly between ages 50-55 in women, while it is seen in older ages in men. The current approach to RA is early and aggressive.If it is not treated or treated late, permanent deformities occur in many of the patients within ten years. If the family physician observes symmetric pain and swelling in minor joints of hands and feet, and morning stiffness in 50-55 years old women, he should consult the patient to a specialist in physical medicine and rehabilitation.

Keywords:

Rheumatoid arthritis, first step health care, age gets,

PDF

___

1. Luqmani R , Hennell S, Estrach C, Birrell F, Bosworth A, Davenport G, et al. On Behalf Of The British Society For Rheumatology And British Health Professionals In Rheumatology Standards, Guidelines And Audit Working Group: British Society for Rheumatology and British Health Professionals in Rheumatology Guideline for the Management of Rheumatoid Arthritis (the first two years). Rheumatology (Oxford) 2006, 45:1167-1169.
2. Lee DM, Weinblatt ME. Rheumatoid arthritis. Lancet. 2001;358:903-911.
3. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988; 31:315-24.
4. Fries JF, Spitz P, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis Rheum 1980;23:137-145.
5. Pincus T, Sokka T. How can the risk of long-term consequences of rheumatoid arthritis be reduced? Best Pract Res Clin Rheumatol. 2001;15:139-170.
6. Wolfe F, Rasker JJ, Boers M, Wells GA, Michaud K. Minimal disease activity, remission, and the long-term outcomes of rheumatoid arthritis. Arthritis Rheum. 2007;57:935- 942.
7. Pincus T, Callahan LF. Taking mortality in rheumatoid arthritis seriously--predictive markers, socioeconomic status and comorbidity. J Rheumatol. 1986;13:841-845.
8. Lee HS, Irigoyen P, Kern M. Interaction between smoking, the shared epitope, and anti-cyclic citrullinated peptide: a mixed picture in three large North American rheumatoid arthritis cohorts. Arthritis Rheum. 2007;56:1745-1753.
9. Deighton C, O’Mahony R,; Tosh J, Turner C, Rudolf M. Management of rheumatoid arthritis: summary of NICE guidance, BMJ Publishing Group Ltd 2009, BMJ. 2009; 338: b702.