抄録
Objective: Biologic treatment is known for its slow efficacy when switching drug classes for patients with rheumatoid arthritis (RA). We developed a new useful method to acquire a quicker response to biologic agents when switching drug class, called the K-method. The purpose of this study was to investigate the efficacy of the K-method for golimumab in patients with RA for up to 24 weeks.
Methods: The K-method uses 40 mg of triamcinolone acetonide (Kenacort-A®) 1 ml and 2 ml of 1% lidocaine hydrochloride (Xylocaine®) via an injection into the swelling or painful joints on the same day of biologic treatment. Ten cases using the K-method with golimumab, included one male and nine females, with a mean age of 69.8 years, and a mean disease duration of 12.4 years. The patients used an average of 7.3 mg/week of methotrexate and 3.3 mg/day of prednisolone. Analyses were carried out with respect to the C-reactive protein (CRP), Disease Activity Score with CRP (DAS28-CRP), and matrix metalloproteinase (MMP-3) for up to 24 weeks.
Results: The mean DAS28-CRP decreased from 5.94 to 3.80 at four weeks and to 2.58 at 24 weeks, respectively. The mean CRP changed from 4.4 mg/dl to 1.4 mg/dl at four weeks and to 1.3 mg/dl at 24 weeks, respectively. The mean MMP-3 changed from 296 ng/ml to 213 ng/ml at four weeks and to 173 ng/ml at 24 weeks, respectively. The European League Against Rheumatism response of the K-method was 70% in the good category and 30% in the moderate category after one day and more than a moderate response in all cases up to 24 weeks. No side effect was recognized using the K-method for up to 24 weeks.
Conclusion: The K-method is useful when switching drug classes to biologic agents to acquire a higher rate of good response from the first day with it being a safe procedure in daily practical RA treatment.
