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MR Vol.13 No.1 indexに戻る
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MODERN RHEUMATOLOGY
Vol.13 No.1 |
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Outcome of patients with rheumatoid arthritis
treated by step-wise administration of disease-modifying antirheumatic
drugs over a 10-year period |
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| Y. Hamada1, F. Shinomiya1, M. Okada1, T.
Fujimura1 |
| (1)Department of Orthopaedic Surgery and Rheumatology,
Tokushima Kensei (CO-OP) Hospital, 4-9-1 Shimosuketou,Tokushima 770-0805,
Japan |
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| Abstract |
| Abstract Disease-modifying antirheumatic drugs
(DMARDs) are expected to relieve polyarthritis, and thereby improve
the patient's quality of life and eventually alter the prognosis
of rheumatoid arthritis (RA) or the progressive joint destruction
caused by it. DMARDs may cause adverse reactions and become less
effective over time in some patients. Using changes in disease activity
and X-ray findings as indicators, we retrospectively evaluated the
long-term results of the step-wise administration of DMARDs in 200
patients with RA. The patients had been treated with gold compounds,
SH compounds, and methotrexate, in this order, over a total of 10
years since initially being diagnosed with the disease in its relatively
early stages. The step-wise administration of DMARDs had decreased
and controlled RA activity and inflammatory response over the 10
years. Although X-ray findings for the wrists worsened over time
in most of the patients, no knee or hip joint destruction was observed
in patients in whom disease activity had been controlled well for
a long period of time. The progression of destruction of major joints
can be prevented in cases in which the Lansbury activity index and
C-reactive protein are maintained at levels not more than 30% and
1.5 mg/dl, respectively. Since no drugs are now available which specifically
prevent the progression of joint destruction, it is important to
control RA activity for as long as possible. |
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| Key words |
| Key words Disease activity ・ Disease-modifying
antirheumatic drug (DMARDs) ・ Long-term outcome ・ Step-wise administration
・ X-ray
finding |
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