{"id":4752,"date":"2022-06-01T14:16:40","date_gmt":"2022-06-01T06:16:40","guid":{"rendered":"http:\/\/web.csh.org.tw\/web\/cshmagazine\/?p=4752"},"modified":"2022-06-01T16:09:05","modified_gmt":"2022-06-01T08:09:05","slug":"%e8%84%8a%e6%a4%8e%e9%97%9c%e7%af%80%e7%82%8e%e7%9a%84%e6%b2%bb%e7%99%82-%e5%90%ab%e5%83%b5%e7%9b%b4%e6%80%a7%e8%84%8a%e6%a4%8e%e7%82%8e%e5%8f%8a%e4%b9%be%e7%99%ac%e6%80%a7%e9%97%9c%e7%af%80%e7%82%8e","status":"publish","type":"post","link":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/?p=4752","title":{"rendered":"\u810a\u690e\u95dc\u7bc0\u708e\u7684\u6cbb\u7642 (\u542b\u50f5\u76f4\u6027\u810a\u690e\u708e\u53ca\u4e7e\u766c\u6027\u95dc\u7bc0\u708e)"},"content":{"rendered":"\n<p style=\"text-align:right\"><strong>\u6587\/\u9b4f\u6b63\u5b97 \u526f\u9662\u9577\u66a8\u98a8\u6fd5\u75c5\u91ab\u5b78\u6703\u810a\u690e\u95dc\u7bc0\u708e\u5c0f\u7d44<\/strong><\/p>\n\n\n\n<p>\u3000\u3000\u810a\u690e\u95dc\u7bc0\u708e(spondyloarthritis, \u7c21\u7a31SpA) \u904e\u53bb\u7a31\u70ba\u8840\u6e05\u9670\u6027\u810a\u690e\u95dc\u7bc0\u75c5\u8b8a(seronegative\nspondyloarthropathy)\u662f\u4e00\u7a2e\u6162\u6027\u767c\u708e\u6027\u4e4b\u810a\u690e\u95dc\u7bc0\u75be\u75c5\u00b9\u3002\u4e3b\u8981\u7684\u81e8\u5e8a\u75c7\u72c0\u662f\u810a\u690e\u53ca\u5468\u908a\u95dc\u7bc0\u7684\u767c\u708e\uff0c\u4ee5\u53ca\u808c\u8171\u9644\u8457\u9ede\u75c5\u8b8a(enthesopathy)\uff0c\u540c\u6642\u4e5f\u670940%\u7684\u75c5\u4eba\u6709\u95dc\u7bc0\u5916\u7684\u8868\u73fe (extra-articular manifestations, EAM)\u3002 \u810a\u690e\u95dc\u7bc0\u708e\u7684\u6cbb\u7642\u76ee\u6a19\u662f\u63a7\u5236\u767c\u708e\u75c7\u72c0\u3001\u907f\u514d\u6301\u7e8c\u6027\u7684\u95dc\u7bc0\u548c\u7d44\u7e54\u7834\u58de\u3001\u4fdd\u6301\u548c\u6062\u5fa9\u6b63\u5e38\u529f\u80fd\u3001\u4ee5\u4fbf\u9039\u5230\u826f\u597d\u751f\u6d3b\u54c1\u8cea\u00b2\u3002\u6cbb\u7642\u7684\u539f\u5247\u6839\u64da\u81e8\u5e8a\u75c7\u72c0\uff0c\u56e0\u4eba\u800c\u7570\u3002\u4e3b\u8981\u53ef\u4ee5\u6982\u5206\u70ba\u4ee5\u810a\u690e\u70ba\u4e3b\u8981\u75c7\u72c0\u4e4b\u4e2d\u8ef8\u578b\u810a\u690e\u95dc\u7bc0\u708e(axial spondyloarthritis)\u53ca\u4ee5\u5468\u908a\u95dc\u7bc0\u708e\u70ba\u4e3b\u8981\u75c7\u72c0\u4e4b\u5468\u908a\u578b\u810a\u690e\u95dc\u7bc0\u708e(peripheral\nspondyloarthritis)\u3002\u8332\u5206\u5225\u6982\u8ff0\u5982\u4e0b\uff1a<\/p>\n\n\n\n<p><strong>\u4e2d\u8ef8\u578b\u810a\u690e\u95dc\u7bc0\u708e(axial spondyloarthritis, axial SpA)<\/strong><\/p>\n\n\n\n<p>\u3000\u3000\u4e2d\u8ef8\u578b\u810a\u690e\u95dc\u7bc0\u708e\u4ee3\u8868\u7684\u75be\u75c5\u662f\u50f5\u76f4\u6027\u810a\u690e\u708e(ankyllsing\nposndylitis, AS)\uff0c\u4ee5\u53ca\u7121\u653e\u5c04\u7dda\u5b78\u7570\u5e38\u4e4b\u4e2d\u8ef8\u578b\u810a\u690e\u95dc\u7bc0\u708e(non-radiographic axial\nspondyloarthritis, nr-axSpA)\u3002\u4e3b\u8981\u7684\u6cbb\u7642\u7b56\u7565\u53ca\u85e5\u7269\u5305\u62ec\u00b3\uff1a<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>\u975e\u85e5\u7269\u6cbb\u7642<\/strong>\uff1a\u5305\u62ec\u751f\u6d3b\u5f62\u614b\u7684\u6539\u5584\u3001\u898f\u5f8b\u904b\u52d5\u3001\u5fa9\u5065\u6cbb\u7642\u3001\u6212\u7159\u4ee5\u53ca\u793e\u6703\u53ca\u5fc3\u7406\u7684\u652f\u6301\u3002\u7279\u5225\u662f\u904b\u52d5\uff0c\u662f\u7dad\u6301\u75c5\u4eba\u529f\u80fd\u53ca\u904b\u52d5\u7bc4\u570d\u7684\u6709\u6548\u6cbb\u7642\uff0c\u63a8\u85a6\u6eab\u548c\u6709\u6c27\u4e4b\u904b\u52d5\uff0c\u4f8b\u5982\u6e38\u6cf3\uff0c\u4f38\u5c55\u904b\u52d5\uff0c\u540c\u6642\u61c9\u907f\u514d\u904b\u52d5\u50b7\u5bb3\u3002\u6212\u7159\u4e5f\u662f\u91cd\u8981\u7684\u6cbb\u7642\u53ca\u9810\u9632\u60e1\u5316\u4e4b\u7b56\u7565\uff0c\u62bd\u7159\u4e4b\u75c5\u4eba\uff0c\u4e0d\u53ea\u5f71\u97ff\u56b4\u91cd\u5ea6\uff0c\u540c\u6642\u4e5f\u5f71\u97ff\u85e5\u7269\u7684\u6cbb\u7642\u6548\u679c\uff0c\u56e0\u7a4d\u6975\u5efa\u8b70\u75c5\u4eba\u6212\u7159\u3002\u4e26\u7121\u7279\u6b8a\u4e4b\u6709\u6548\u98f2\u98df\uff0c\u4f46\u56e0\u810a\u690e\u95dc\u7bc0\u708e\u75c5\u4eba\u5bb9\u6613\u7f79\u60a3\u5fc3\u8840\u7ba1\u75be\u75c5\u53ca\u9aa8\u8cea\u758f\u9b06\u75c7\uff0c\u98f2\u98df\u7684\u539f\u5247\u662f\u4f4e\u6cb9\u4f4e\u9e7d\u540c\u6642\u9ad8\u9223\u4e26\u9069\u6642\u5730\u88dc\u5145\u7dad\u4ed6\u547dD3\u4ee5\u9810\u9632\u4f75\u767c\u75c7\u3002<\/li><li><strong>\u975e\u985e\u56fa\u9187\u6297\u767c\u708e\u85e5\u7269 (non-steroidal\nanti-inflammatory drugs, NSAID)<\/strong>\uff1a\u662f\u810a\u690e\u95dc\u7bc0\u708e\u75c5\u4eba\u6700\u5e38\u7528\u7684\u85e5\u7269\u6cbb\u7642\uff0c\u53ef\u4ee5\u6709\u6548\u5730\u63a7\u5236\u75c7\u72c0\u53ca\u767c\u708e\u7a0b\u5ea6\u3002\u4f46\u9700\u6ce8\u610f\u9577\u671f\u5927\u91cf\u4f7f\u7528\u5bb9\u6613\u5c0e\u81f4\u80c3\u8178\u526f\u4f5c\u7528\uff0c\u6545\u5efa\u8b70\u4ee5\u6700\u4f4e\u6709\u6548\u5291\u91cf\uff0c\u540c\u6642\u76e1\u91cf\u9078\u7528\u6bd4\u8f03\u4e0d\u50b7\u80c3\u4e4b\u9078\u64c7\u6027COX-2\u6291\u5236\u5291\uff0c\u5982meloxicm\u3001celecoxib\u53caetoricoxib\u4ee5\u9810\u9632\u8178\u80c3\u526f\u4f5c\u7528\u3002\u6709\u90e8\u5206\u8b49\u64da\u986f\u793a\uff0cNSAID\u85e5\u7269\u6709\u53ef\u80fd\u6e1b\u5c11\u5f71\u50cf\u5b78\u7684\u9032\u5c55\uff0c\u5efa\u8b70\u65bc\u75be\u75c5\u6d3b\u6027\u9ad8\u4e4b\u75c5\u4eba\uff0c\u7279\u5225\u662fC\u53cd\u61c9\u86cb\u767d\u904e\u9ad8\uff0c\u810a\u690e\u5df2\u6709\u9aa8\u8d05\u7684\u751f\u6210\uff0c\u4ee5\u53ca\u62bd\u7159\u60a3\u8005\uff0c\u6bcf\u65e5\u4f7f\u7528\u6700\u4f4e\u6709\u6548\u5291\u91cf\uff0c\u4ee5\u6709\u6548\u63a7\u5236\u767c\u708e\u4e26\u6e1b\u7de9\u810a\u690e\u878d\u5408\u60e1\u5316\u3002\u82e5\u75c5\u4eba\u75be\u75c5\u6d3b\u6027\u4e0d\u9ad8\uff0c\u53ef\u4ee5\u6709\u75db\u6642\u6309\u9700\u6c42\u670d\u7528\u5373\u53ef\u3002<\/li><li><strong>\u50b3\u7d71\u514d\u75ab\u8abf\u7bc0\u5291 (disease-modifying\nanti-rheumatic drugs, DMARDs)<\/strong>\uff1a\u76ee\u524d\u6700\u5e38\u7528\u4e4b\u53e3\u670d\u50b3\u7d71\u514d\u75ab\u8abf\u7bc0\u5291\u70basulfasalazine\uff0c\u5efa\u8b70\u7528\u65bc\u5408\u4f75\u5468\u908a\u95dc\u7bc0\u708e\u4e4b\u75c5\u4eba\u6216\u6709\u95dc\u7bc0\u5916\u8868\u73fe\uff0c\u4f8b\u5982\u8679\u819c\u708e\u3001\u4e7e\u766c\u6216\u5927\u8178\u708e\u4e4b\u75c5\u4eba\u3002\u5c0d\u55ae\u7d14\u810a\u690e\u4fb5\u72af\u4e4b\u75c5\u4eba\uff0c\u7642\u6548\u8f03\u5dee\u3002<\/li><li><strong>\u751f\u7269\u88fd\u5291 (biologics)<\/strong>\uff1a\u662f\u76ee\u524d\u6cbb\u7642\u50f5\u76f4\u6027\u810a\u690e\u708e\u4e4b\u6700\u6709\u6548\u85e5\u7269\u3002\u76ee\u524d\u5df2\u6838\u53ef\u6cbb\u7642\u50f5\u76f4\u6027\u810a\u690e\u708e\u4e4b\u751f\u7269\u88fd\u5291\u6709\u6297\u816b\u7624\u58de\u6b7b\u56e0\u5b50\u751f\u7269\u88fd\u5291(anti-TNF\u03b1)\u53ca\u6297\u767d\u4ecb17\u751f\u7269\u88fd\u5291(anti-IL17)\u5169\u5927\u6a5f\u8f49\u3002\u6297\u816b\u7624\u58de\u6b7b\u56e0\u5b50\u88fd\u5291\u6709etanercept(Enbrel)\u3001infliximab(Remecade)\u3001adalimumab(Humira)\u3001golimumab(Simponi) \u53cacertolizumab\npegol(Cimzia) \u7b49\u4e94\u7a2e\u85e5\u7269\uff0c\u7686\u70ba\u76ae\u4e0b\u6ce8\u5c04\u7d00\u884c\uff0c\u6ce8\u5c04\u983b\u7387\u70ba\u6bcf\u9031\u5230\u6bcf\u56db\u9031\u4e00\u6b21\u4e0d\u7b49\u3002 \u5404\u7a2e\u85e5\u7269\u5c0d\u810a\u690e\u53ca\u5468\u908a\u95dc\u7bc0\u4e4b\u6709\u6548\u6027\u5927\u81f4\u76f8\u7576\uff0cASAS20\u6709\u6548\u7387\u7d0460-80%\u3002\u4f46\u5c0d\u95dc\u7bc0\u5916\u4e4b\u75c7\u72c0\uff0c\u55ae\u682a\u6297\u9ad4\u985e\u85e5\u7269\u7642\u6548\u512a\u65bc\u878d\u5408\u86cb\u767d\u985e\u85e5\u7269\u3002<\/li><li><strong>\u6297\u767d\u4ecb17<\/strong><strong>\u751f\u7269\u88fd\u5291<\/strong>\uff1a\u5df2\u6709secukinumab(Cosentyx)\u53caixikizumab(Taltz)\u5728\u53f0\u4e0a\u5e02\uff0c\u76ee\u524d\u6838\u53ef\u9069\u61c9\u75c7\u70ba\u4e7e\u766c\uff0c\u4e7e\u766c\u95dc\u7bc0\u708e\u53ca\u50f5\u76f4\u6027\u810a\u690e\u708e\u3002<\/li><\/ul>\n\n\n\n<p>\u3000\u30002018\u5e74\u4e2d\u83ef\u6c11\u570b\u98a8\u6fd5\u75c5\u91ab\u5b78\u6703\u810a\u690e\u95dc\u7bc0\u708e\u4efb\u52d9\u5c0f\u7d44\u7a0b\u88fd\u8a02\u4e4b\u4e2d\u8ef8\u578b\u810a\u690e\u95dc\u7bc0\u708e\u4e4b\u6cbb\u7642\u5171\u8b58\uff0c\u5efa\u8b70\u6bcf\u9694\u4e09\u5230\u516d\u500b\u6708\u8a55\u4f30\u75c5\u4eba\u4e4b\u75be\u75c5\u6d3b\u6027\uff0c\u6cbb\u7642\u672a\u9054\u6a19\u7684\u75c5\u4eba\u61c9\u8a72\u5347\u968e\u6cbb\u7642\uff0c\u9032\u884c\u751f\u7269\u88fd\u5291\u6cbb\u7642\u4e4b\u524d\u61c9\u8a72\u9032\u884c\u98a8\u96aa\u7ba1\u7406\u8a08\u5283\u3002<\/p>\n\n\n\n<p><strong>\u5468\u908a\u578b\u810a\u690e\u95dc\u7bc0\u708e( peripheral spondyloarthritis)<\/strong><\/p>\n\n\n\n<p>\u3000\u3000\u5468\u908a\u578b\u810a\u690e\u95dc\u7bc0\u708e\u4ee3\u8868\u6027\u7684\u75be\u75c5\u662f\u4e7e\u766c\u6027\u95dc\u7bc0\u708e(pasoriatic\narthritis, PsA)\u3002\u4e7e\u766c\u6027\u95dc\u7bc0\u708e\u7684\u6cbb\u7642\u9808\u7531\u98a8\u6fd5\u79d1\u53ca\u76ae\u819a\u79d1\u4ee5\u53ca\u5176\u4ed6\u76f8\u95dc\u79d1\u7684\u5171\u540c\u7167\u8b77\uff0c\u6cbb\u7642\u7684\u539f\u5247\u4e5f\u5fc5\u9808\u56e0\u500b\u5225\u75c5\u4eba\u4e4b\u4e3b\u8981\u75c7\u72c0\u6216\u5f71\u97ff\u5668\u5b98\u800c\u5b9a\u3002\u4e3b\u8981\u7684\u8003\u91cf\u75c7\u72c0\u70ba\u810a\u690e\u3001\u5468\u908a\u95dc\u7bc0\u3001\u76ae\u819a\u3001\u9644\u8457\u9ede\u708e(enthesitis)\u53ca\u6307\u708e(dactylitis)\u7b49\u75c7\u72c0\u2074\u3002<\/p>\n\n\n\n<p>\u3000\u3000\u5982\u540c\u50f5\u76f4\u6027\u810a\u690e\u708e\uff0c\u4e7e\u766c\u6027\u95dc\u7bc0\u708e(PsA)\u4e4b\u9aa8\u9abc\u95dc\u7bc0\u75c7\u72c0\u7684\u50b3\u7d71\u6cbb\u7642\u70ba\u751f\u6d3b\u5f62\u614b\u7684\u6539\u5584\uff0c\u975e\u985e\u56fa\u9187\u6297\u767c\u708e\u85e5\u7269(non-steroidal anti-inflammatory drugs, NSAIDs)\u548c\u514d\u75ab\u8abf\u7bc0\u5291(disease-modifying anti-rheumatic drugs, DMARDs)\u3002\u4f46\u8207\u50f5\u76f4\u6027\u810a\u690e\u708e\u4e0d\u540c\u7684\u662f\uff0c\u5468\u908a\u578b\u810a\u690e\u95dc\u7bc0\u708e\u6709\u6bd4\u8f03\u591a\u7684DMARDs\u9078\u64c7\uff0c\u5982 sulfasalazine\u3001 methotraxate\u3001cyclosporine\u53caleflunamide\u7b49\u3002\u5fc5\u8981\u6642\uff0c\u53ef\u4ee5\u4f7f\u75282\u81f33\u7a2e\u514d\u75ab\u8abf\u7bc0\u5291\u806f\u5408\u6cbb\u7642\u3002<\/p>\n\n\n\n<p>\u3000\u3000\u4e7e\u766c\u95dc\u7bc0\u708e\u4e4b\u514d\u75ab\u6a19\u9776\u6cbb\u7642\u8fd1\u5e74\u4f86\u9032\u5c55\u5feb\u901f\uff0c\u4e3b\u8981\u5206\u70ba\u751f\u7269\u88fd\u5291\u53ca\u5c0f\u5206\u5b50\u85e5\u7269\u3002\u751f\u7269\u88fd\u5291\u5982TNF\u3001IL17\u3001 IL12\/23\u3001 IL23\u6291\u5236\u5291\u90fd\u5df2\u6838\u53ef\u4e0a\u5e02\u3002\u5c0d\u5468\u908a\u95dc\u7bc0\u708e\uff0c\u5404\u7a2e\u751f\u7269\u88fd\u5291\u57fa\u672c\u4e0a\u7642\u6548\u76f8\u7576\u3002\u4f46\u5c0d\u810a\u690e\u708e\uff0c\u5efa\u8b70\u4f7f\u7528TNF(\u5982adalimumab\u3001golimumab\u3001etanercept)\u6216IL17\u6291\u5236\u5291(\u5982secukinumab\u3001ixekizumab)\u3002\u91dd\u5c0d\u76ae\u819a\u4e7e\u766c\uff0c\u5247\u4ee5IL17\u3001IL12\/23\u6291\u5236\u5291(ustekinumab)\u53caIL23\u6291\u5236\u5291(\u5982guselkumab)\u7642\u6548\u8f03\u4f73\u3002<\/p>\n\n\n\n<p>\u3000\u3000\u53e3\u670d\u5c0f\u5206\u5b50\u85e5\u7269\u76ee\u524d\u5df2\u6709Tofacitinib\u53caBaricitinib\u5728\u53f0\u7063\u4e0a\u5e02\uff0c\u7642\u6548\u4e0d\u4e9e\u65bc\u751f\u7269\u88fd\u5291\uff0c\u4f7f\u7528\u65b9\u4fbf\u3002\u5982\u540c\u751f\u7269\u88fd\u5291\uff0c\u90fd\u9700\u5411\u5065\u4fdd\u7f72\u4e8b\u524d\u7533\u8acb\uff0c\u4e26\u9032\u884c\u98a8\u96aa\u7ba1\u7406\u8a08\u5283\u3002<\/p>\n\n\n\n<p><strong>\u7e3d\u7d50<\/strong><\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignright is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/web.csh.org.tw\/web\/cshmagazine\/wp-content\/uploads\/2022\/06\/11106-01.jpg\" alt=\"\" class=\"wp-image-4759\" width=\"394\" height=\"256\"\/><figcaption>\u904e\u654f\u514d\u75ab\u98a8\u6fd5\u79d1 \u9b4f\u6b63\u5b97\u91ab\u5e2b<\/figcaption><\/figure><\/div>\n\n\n\n<p>\u3000\u3000\u810a\u690e\u95dc\u7bc0\u708e\u4e4b\u6cbb\u7642\u61c9\u6709\u98a8\u6fd5\u79d1\u91ab\u5e2b\u5354\u540c\u76f8\u95dc\u5c08\u79d1\u5171\u540c\u7167\u8b77\uff0c\u540c\u6642\u61c9\u8207\u75c5\u4eba\u8a0e\u8ad6\u4e4b\u5f8c\u6c7a\u5b9a\u2075\u3002\u975e\u85e5\u7269\u6cbb\u7642\u5982\u904b\u52d5\u3001\u7269\u7406\u6cbb\u7642\u3001\u6212\u7159\u53ca\u5fc3\u7406\u652f\u6301\u70ba\u57fa\u672c\u6cbb\u7642\u3002\u85e5\u7269\u6cbb\u7642\u8fd1\u5e74\u4f86\u9032\u5c55\u8fc5\u901f\uff0c\u514d\u75ab\u6a19\u9776\u85e5\u7269\u76f8\u7e7c\u4e0a\u5e02\uff0c\u53ef\u5206\u70ba\u751f\u7269\u88fd\u5291\u548c\u5c0f\u5206\u5b50\u85e5\u7269\u3002\u81e8\u5e8a\u91ab\u5e2b\u56e0\u91dd\u5c0d\u500b\u5225\u75c5\u4eba\u4e4b\u75c7\u72c0\u53ca\u9700\u6c42\uff0c\u9078\u64c7\u9069\u7576\u85e5\u7269\uff0c\u540c\u6642\u517c\u9867\u7642\u6548\u53ca\u5b89\u5168\u6027\uff0c\u4ee5\u7d42\u751f\u9577\u671f\u9054\u6a19\u6cbb\u7642\u70ba\u76ee\u6a19\u3002<\/p>\n\n\n\n<p><strong>\u53c3\u8003\u6587\u737b<\/strong><\/p>\n\n\n\n<p>1.Dougados M, van der Linden S, Juhlin R,\nHuitfeldt B, Amor B, Calin A: The European Spondylarthropathy Study Group\npreliminary criteria for the classification of spondylarthropathy. Arthritis\nand rheumatism. 1991;34(10):1218-27.<\/p>\n\n\n\n<p>2.Smolen JS, Braun J, Dougados M, Emery P,\nFitzgerald O, Helliwell P, Kavanaugh A, Kvien TK, Landew\u00e9 R, Luger T, Mease P,\nOlivieri I, Reveille J,Ritchlin C, Rudwaleit M, Schoels M, Sieper J, Wit Md,\nBaraliakos X, Betteridge N, Burgos-Vargas R, Collantes-Estevez E, Deodhar A,\nElewaut D, Gossec L, Jongkees M, Maccarone M, Redlich K, van den Bosch F, Wei\nJC, Winthrop K, van der Heijde D. Treating spondyloarthritis, including ankylosing\nspondylitis and psoriatic arthritis, to target: recommendations of an\ninternational task force. Ann Rheum Dis. 2014 Jan;73(1):6-16.<\/p>\n\n\n\n<p>3.van der Heijde D, Ramiro S, Landew\u00e9 R,\nBaraliakos X, Van den Bosch F, Sepriano A, Regel A, Ciurea A, Dagfinrud H,\nDougados M, van Gaalen F, G\u00e9her P, van der Horst-Bruinsma I, Inman RD, Jongkees\nM, Kiltz U, Kvien TK, Machado PM, Marzo-Ortega H, Molto A, Navarro-Comp\u00e0n V,\nOzgocmen S, Pimentel-Santos FM, Reveille J, Rudwaleit M, Sieper J,\nSampaio-Barros P, Wiek D, Braun J. 2016 update of the ASAS-EULAR management recommendations\nfor axial spondyloarthritis. Ann Rheum Dis. 2017 Jun;76(6):978-991.<\/p>\n\n\n\n<p>4.Coates LC, Gossec L, Ramiro S, Mease P,\nvan der Heijde D, Smolen JS, Ritchlin C, Kavanaugh A. New GRAPPA and EULAR\nrecommendations for the management of psoriatic arthritis. Rheumatology\n(Oxford). 2017 Aug 1;56(8):1251-1253.<\/p>\n\n\n\n<p>5.Tam LS, Wei JC, Aggarwal A, Baek HJ,\nCheung PP, Chiowchanwisawakit P, Dans L, Gu J, Hagino N, Kishimoto M, Reyes HM,\nSoroosh S, Stebbings S, Whittle S, Yeap SS, Lau CS. 2018 APLAR axial\nspondyloarthritis treatment recommendations. Int J Rheum Dis. 2019 Mar;22(3):340-356.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u6587\/\u9b4f\u6b63\u5b97 \u526f\u9662\u9577\u66a8\u98a8\u6fd5\u75c5\u91ab\u5b78\u6703\u810a\u690e\u95dc\u7bc0\u708e\u5c0f\u7d44 \u3000\u3000\u810a\u690e\u95dc\u7bc0\u708e(spondyloarthritis, \u7c21\u7a31Sp [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19],"tags":[123,71,219,217],"class_list":["post-4752","post","type-post","status-publish","format-standard","hentry","category-19","tag-123","tag-71","tag-219","tag-217"],"_links":{"self":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts\/4752"}],"collection":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4752"}],"version-history":[{"count":3,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts\/4752\/revisions"}],"predecessor-version":[{"id":4763,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts\/4752\/revisions\/4763"}],"wp:attachment":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4752"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4752"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4752"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}