medicina61巻1号

2024年01月発行

特集 その知見は臨床を変える?—エキスパートが解説! 内科における最新論文 膠原病と類縁疾患

関節リウマチの最新治療

著者： 安田卓矢¹ 萩野昇¹

所属機関： ¹帝京大学ちば総合医療センター血液・リウマチ内科

ページ範囲：P.131 - P.135

Point
◎関節リウマチの治療目標は速やかな臨床的寛解達成であり，禁忌事項のほかに年齢・腎機能・肺合併症を考慮してメトトレキサート（MTX）の適応の有無と開始量を判断する．
◎オゾラリズマブは日本初のナノボディー製剤であり，速やかな効果発現が期待できるが，安全性については慎重に判断する必要がある．
◎MTXの皮下注射製剤は，経口薬に比べて嘔気などの消化器症状が少なく，生物学的製剤/JAK阻害薬に比べ安価である．

参考文献

1）日本リウマチ学会（編）：関節リウマチ診療ガイドライン2020．診断と治療社，2021

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compound ozoralizumab in patients with rheumatoid arthritis and an inadequate response to methotrexate；A 52-week result of a phase Ⅱ/Ⅲ study（OHZORA trial）. Mod Rheumatol 33：883-890, 2023 PMID 36197757

compound ‘ozoralizumab' without methotrexate co-administration in patients with active rheumatoid arthritis；A 52-week result of phase Ⅲ, randomised, open-label trial（NATSUZORA trial）. Mod Rheumatol 33：875-882, 2023 PMID 36201360

10）Felson DT, et al：The American College of Rheumatology preliminary core set of disease activity measures for rheumatoid arthritis clinical trials. The Committee on Outcome Measures in Rheumatoid Arthritis Clinical Trials. Arthritis Rheum 36：729-740, 1993 PMID 8507213

11）Wunder A, et al：Albumin-based drug delivery as novel therapeutic approach for rheumatoid arthritis. J Immunol 170：4793-4801, 2003 PMID 1270736

compound, exhibits efficacy not only at the onset of arthritis in a human TNF transgenic mouse but also during secondary failure of administration of an anti-TNFα IgG. Front Immunol 13：853008, 2022 PMID 35273620