Abstract
Object: The number of rheumatoid arthritis (RA) patients treated with anti-tumor necrosis-α (anti-TNF-α) is rapidly increasing. However, some cases show an inadequate response to anti-TNF-αor reduction in effectiveness during long-term treatment.
This report describes the efficacy of tacrolimus combination therapy in RA patients that showed an inadequate response to infliximab.
Methods: Six RA patients (5 females, one male, mean age 61±6.44 yrs, mean disease duration 7.3±2.94 yrs) who had shown an inadequate responses to infliximab were treated with tacrolimus combination therapy. The effectiveness was evaluated based on the clinical joint symptoms, CRP, VAS, and DAS28CRP at 3 months later and at the final follow-up.
Results: The mean value of tender joint scores decreased from 9.2 to 5.0, that of swelling joint score decreased from 8.0 to 3.3, mean value of patient’s global assessment of disease status using visual analogue scale (VAS) decreased from 67.0 to 41.2, the mean CRP level decreased from 4.6 to 1.4 mg/dl, and the mean DAS28CRP decreased from 5.6 to 3.8. The results showed that1of 6 high activity patients was in remission, while 2 patients showed moderate activity at the last observation. No serious adverse events were observed during the follow-up periods in any of the patients.
Conclusion: These results suggest that tacrolimus combination therapy may therefore be a useful method for rheumatoid arthritis patients that show an inadequate response to infliximab.
