並列タイトル等治療抵抗性の関節リウマチの臨床的・超音波検査の特徴 多施設共同関節リウマチ超音波コホート研究
タイトル(掲載誌)Scandinavian Journal of Rheumatology
授与機関名Nagasaki University (長崎大学)
一般注記Objective: The optimal strategy for difficult-to-treat (D2T) rheumatoid arthritis (RA) has not been identified, and the ultrasound characteristics of D2T RA have not been reported. We investigated the clinical characteristics and factors contributing to the outcome in D2T RA in a multicentre RA ultrasound observational cohort. Method: We reviewed 307 Japanese patients diagnosed with RA who underwent treatment with biological and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). We compared the differences in patient characteristics between the D2T RA and non-D2T RA groups. We examined the factors contributing to a good response [defined as b/tsDMARD continuation and Clinical Disease Activity Index (CDAI) ≤ 10 at 12 months] in the D2T RA patient group. Results: Forty-three patients (14%) were categorized as D2T RA and the remaining 264 (86%) as non-D2T RA at baseline. The grey-scale (GS) score, disease duration, and CDAI at the initiation of treatment were significantly higher in the D2T RA group than in the non-D2T RA group. In contrast, the power Doppler (PD) score was not significantly different between the two groups. Of the 43 D2T RA patients, 20 achieved a good response. The introduction of CTLA4-Ig (n = 5) was significantly associated with a good response in analysis based on inverse probability weighting with propensity score. GS and PD scores at baseline were not significantly associated with therapeutic response at 12 months in D2T RA patients. Conclusions: Patients with D2T RA had high clinical and ultrasound activity and poor responses to treatment with b/tsDMARDs. CTLA4-Ig was associated with a good response at 12 months in D2T RA patients.
長崎大学学位論文 学位記番号:共博(医歯薬)甲第36号 学位授与年月日:令和6年3月6日
Author: T Michitsuji, S Fukui, S Morimoto, Y Endo, A Nishino, S Nishihata, Y Tsuji, T Shimizu, M Umeda, R Sumiyoshi, T Koga, N Iwamoto, T Origuchi, Y Ueki, T Yoshitama, N Eiraku, N Matsuoka, A Okada, K Fujikawa, H Ohtsubo, H Takaoka, H Hamada, T Tsuru, M Nawata, Y Arinobu, T Hidaka, Y Tada, A Kawakami, S-Y Kawashiri
Citation: Scandinavian Journal of Rheumatology, 53(2), pp.123-129; 2023
Nagasaki University (長崎大学), 博士(医学) (2024-03-06)
著作権情報© 2023 Scandinavian Journal of Rheumatology Foundation
関連情報(DOI)10.1080/03009742.2023.2277542
連携機関・データベース国立情報学研究所 : 学術機関リポジトリデータベース(IRDB)(機関リポジトリ)