Abstract
Objective: To study the clinical and radiographic efficacy of tacrolimus for patients with rheumatoid arthritis (RA). Methods: We enrolled 24 patients with RA who showed an insufficient response to other disease-modifying antirheumatic drugs (DMARDs). Disease activity and clinical response were evaluated by disease activity score of 28 joints -4/erythrocyte sedimentation rate (DAS28-4/ESR) and European League Against Rheumatism (EULAR) improvement criteria. Joint destruction of eight patients was assessed using the modified total sharp score (mTSS) at baseline and 1 year after the start of tacrolimus therapy. Results: Thirteen patients (54.1%) were evaluated as having a moderate or good response at 1 year after tacrolimus therapy, but tacrolimus was discontinued in nine cases who showed no or inadequate response. The mean values of the estimated yearly progression rate of mTSS at baseline, was 24.3, while that value was 3.62 at 1 year after the start of tacrolimus therapy, indicating the inhibition of joint destruction. Conclusion: Our study suggests that tacrolimus therapy for patients with RA, refractory to other DMARDs, appears to be efficacious not only in controlling the clinical symptoms, but also in suppressing the progression of joint damage.
