生物学的製剤導入により整形外科診療は変わったかインフリキシマブの治療効果と関節手術のタイミング

抄録

    Whether or not arthroplasty improves the sequelae of infliximab therapy in patients with rheumatoid arthritis (RA) was studied in 59 patients with RA. The patients who received arthroplasy during treatment with infliximab (n＝7) were compared with those who did not receive arthroplasy in view of parameters of disease activity. Clinical parameters such as the duration of morning stiffness, grip strength, C-reactive protein value and blood sedimentation rate all continuously improved during 1.5 years of infliximab therapy in the patients who did not receive arthroplasty. However, these parameters that improved once all deteriorated 1.5 years after the start of infliximab therapy in the patients who received arthroplasty. An exception was the number of tender joints, and this parameter was particularly improved after 1.5 years of infliximab therapy in the patients who received arthroplasty. No infectious episodes related to arthroplasty were seen. The results showed that the patients with RA who required arthroplastywere less responsive to infliximab therapy probably because of having a relatively higher level of disease activity other than C-reactive protein values. The results also indicate that arthroplasty performed during infliximab therapy is safe and improves the joint pain of patients with RA.