当科における強直性脊椎炎および乾癬性関節炎の患者背景と治療について

抄録

Objective: We investigated the clinical features and treatment outcomes of Japanese patients with ankylosing spondylitis (AS) and the psoriatic arthritis (PsA) in our hospital.
Methods: From April 2002 to March 2013 inclusive, we diagnosed and treated eight AS patients (4 males and 4 females) and ten PsA patients (5 males and 5 females), respectively. We investigated HLA-B27 positivity and the family histories of the patients in addition to clinical symptoms, the response to non-steroidal anti-inflammatory drugs (NSAIDs), and the effect of anti-tumor necrosis factor (TNF) biologic agents.
Results: Sixty-six percent of AS patients were human leukocyte antigen (HLA)-B27 positive, but a positive family history was found in only 12.5% of all cases. Several patients had HLA testing in those with PsA, but only two cases were HLA-B27 positive. Enthesitis was identified in 35.7% of AS patients and 60% of PsA patients, respectively. NSAID monotherapy produced an insufficient effect for both sets of patients, but especially PsA patients. Anti-TNF biologic agents including infliximab and adalimumab, reduced the Bath Ankylosing Spondylitis Disease Activity Index in AS patients from 5.2 to 2.8, and the Disease Activity Score 28 in PsA patients from 3.82 to 1.75, respectively.
Conclusion: HLA-B27 was a modestly helpful marker for the diagnosis of AS in our Japanese patient study population. Anti-TNF biologic agents had a high efficacy for treatment in both sets of patients with AS and PsA.