Clinical and ultrasound features of difficult-to-treat rheumatoid arthritis: A multicenter RA ultrasound cohort study

• Material Type: 博士論文
• Title: Clinical and ultrasound features of difficult-to-treat rheumatoid arthritis: A multicenter RA ultrasound cohort study
• Author/Editor: 道辻󠄀, 徹
• Author Heading: 道辻󠄀, 徹
• Publication, Distribution, etc.: Taylor & Fransis Group
• Publication Date: 2024-03-06
• Publication Date (W3CDTF): 2024-03-06
• Alternative Title: 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
• Periodical title: Scandinavian Journal of Rheumatology
• No. or year of volume/issue: 53 2
• Volume: 53
• Issue: 2
• Pages: 123-129
• ISSN (Periodical Title): ISSN : 0300-9742
• Degree grantor/type: Nagasaki University (長崎大学)
• Date Granted: 2024-03-06
• Dissertation Number: 甲共医歯薬第36号
• Degree Type: 博士(医学)
• Text Language Code: eng
• Target Audience: 一般
• Note (General): 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)
• Access Restrictions: インターネット公開
• Rights (production): © 2023 Scandinavian Journal of Rheumatology Foundation
• Related Material (URI): HDL; http://hdl.handle.net/10069/0002000765
• Related Material (DOI): 10.1080/03009742.2023.2277542
• Data Provider (Database): 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）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 長崎大学 : 長崎大学学術研究成果リポジトリ