Vol.19 No.6

Original Article

Prediction of DAS28-CRP remission in patients with rheumatoid arthritis treated with tacrolimus at 6 months by baseline variables

Authors

Toshiyuki Aramaki1 , Atsushi Kawakami1 , Naoki Iwamoto1 , Keita Fujikawa1 , Shin-ya Kawashiri1 , Mami Tamai1 , Kazuhiko Arima1 , Makoto Kamachi1 , Satoshi Yamasaki1 , Hideki Nakamura1 , Munetoshi Nakashima2 , Akinari Mizokami3, Masako Furuyama4, Naoki Matsuoka5, Yukitaka Ueki6, Hiroaki Ida1, Tomoki Origuchi7, Kiyoshi Aoyagi8, Katsumi Eguchi1

  • Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
  • The Japanese Red Cross Nagasaki Atomic Bomb Hospital, Nagasaki, Japan
  • Nagasaki Citizen Hospital, Nagasaki, Japan
  • Nagasaki Kita Hospital, Nagasaki, Japan
  • Gotokai Hospital, Nagasaki, Japan
  • Sasebo Chuo Hospital, Sasebo, Japan
  • Nagasaki University School of Health Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan
  • Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
Received:

23 March 2009

Accepted:

14 July 2009

Published online:

29 September 2009

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Abstract

We attempted to determine what baseline variables are responsible for the efficacy of tacrolimus at 6 months in Japanese patients with rheumatoid arthritis (RA). One hundred and six RA patients treated with tacrolimus for 6 months were entered in this study. The outcome was set as the achievement of Disease Activity Score 28 C-reactive protein (DAS28-CRP) remission at 6 months. We examined the association of gender, DAS28-CRP at baseline, concomitant use of methotrexate (MTX), and concomitant use of prednisolone with the achievement of DAS28-CRP remission at 6 months by logistic regression analysis. Twenty-three of 106 patients (21.7%) achieved DAS28-CRP remission at 6 months. There was concomitant use of MTX by 20 patients (18.9%), prednisolone by 93 (87.7%), and prednisolone >5 mg/day by 43 (40.6%) at baseline. Logistic regression analysis showed that male gender (first) and moderate disease activity at baseline (second) are independent predictors toward achieving DAS28-CRP remission at 6 months. Maximum tacrolimus dosage administrated for patients over a 6-month period appeared not to be predictive for the DAS28-CRP remission at 6 months. In conclusion, we revealed for the first time that good outcome in RA patients treated with tacrolimus can be predictive by some baseline variables. That is clinically valuable for daily practice in the choice of disease-modifying antirheumatic drugs (DMARDs), especially tacrolimus.

Key words

DAS - Gender - MTX - Rheumatoid arthritis - Tacrolimus