Vol.19 No.4

Original Article

Tight control is important in patients with rheumatoid arthritis treated with an anti-tumor necrosis factor biological agent: prospective study of 91 cases who used a biological agent for more than 1 year

Authors

Hiroshige Sano1 , Katsumitsu Arai1 , Takehiro Murai1 , Junichi Fujisawa1 , Naoki Kondo1 , Takahiro Netsu1 , Tadamasa Hanyu2 , Takako Saeki2 , Tomoyuki Ito3 , Naoto Endo1

  • Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, 1-754 Asahimachi, Chuoku, Niigata, Niigata 951-8520, Japan
  • Department of Rheumatology, Nagaoka Red Cross Hospital, 2-297-1 Sensyu, Nagaoka, Niigata 940-2085, Japan
  • Department of Internal Medicine, Nagaoka Red Cross Hospital, 2-297-1 Sensyu, Nagaoka, Niigata 940-2085, Japan
Received:

3 December 2008

Accepted:

13 April 2009

Published online:

26 May 2009

Full Text

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Abstract

The purpose of this study is to identify the factors that require arthroplasty due to the progression of joint destruction, even when an anti-tumor necrosis factor (TNF) biological agent is used for rheumatoid arthritis (RA). Among 91 cases that used the anti-TNF biological agent for more than 1 year, two groups of 21 cases that resulted in arthroplasty (surgery group) and 70 cases that did not result in arthroplasty (non-surgery group) were compared and examined. When the anti-TNF biological agent was first administered, disease activity and internal use of glucocorticoid (PSL) were not different in these two groups. The average DAS28-CRP(4) (disease activity score including a 28-joint count/C-reactive protein) (p < 0.001) and the amount of internal use of PSL (p < 0.05) were significantly decreased in the non-surgery group compared with the surgery group at the final survey. To inhibit the need for joint surgery in patients using the anti-TNF biological agent, it is important to maintain tight control over RA activity.

Key words

Rheumatoid arthritis - Anti-TNF biological agent - Disease activity - Arthroplasty - Joint destruction