臨床整形外科50巻2号

2015年02月発行

誌上シンポジウム 関節リウマチ—生物学的製剤使用で変化したこと

関節病変・寛解率の変化

著者： 門野夕峰¹

所属機関： ¹東京大学大学院医学系研究科感覚・運動機能医学整形外科

ページ範囲：P.97 - P.104

　生物学的製剤の登場により関節リウマチの診療は劇的に変化した．臨床的寛解ならびに関節破壊進行抑制が治療目標となり，本邦の実臨床で寛解達成率はBoolean基準でみても25％を超えている．メトトレキサート(MTX)と同等以上の有効性を示し，MTX併用でより有効性が高くなる生物学的製剤だが，効果不十分例に比べて，ナイーブ例で使用するほうが有効性が高い．寛解達成率の上昇とともに関節破壊抑制効果が上昇することも明らかとなり，より早期から導入することで高い臨床的寛解ならびに構造的寛解を達成できることも明らかとなっている．

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