早期関節リウマチ治療における薬物治療と初診時からのリハビリテーション治療併用の有効性

抄録

Objective: Disease-modifying biological agents and other new drugs have improved disease activity and inhibit joint damage in patients with rheumatoid arthritis (RA). This study examined the effectiveness of combination therapy with medications and rehabilitation in patients with early RA.

Methods: The study enrolled 18 patients with early RA (disease duration<1 year) and all the patients were treated with medications targeting the disease. The patients were divided into two groups based on the time of their first visit. One group consisted of 10 patients who underwent occupational therapy (OT) for two months after their first visit to our outpatient clinic. The OT included upper and lower extremity exercises, and education on how to protect theirs hands from damage during daily activity. The other group consisted of the remaining eight patients who were not treated with OT. The changes in the DAS28 score, C-reactive protein, patient’s general health (0～10, 0: best; 10: worst) Health Assessment Questionnaire, and the number of painful joints in the hand were examined for up to six months.

Results: At the first visit, in the patients undergoing OT, the DAS28 score and patient’s general health were 5.3±1.5 (mean±SD) and 7.8±2.2, respectively, and 5.8±1.7 and 8.5±2.5 in the remaining patients. At one month, in the OT patients, the DAS28 score and patient’s general health were 3.1±1.4 and 2.3±1.6, and 4.8±2.0 and 5.5±3.3 in the remaining patients, respectively. Improvement of the patients’ general health and DAS28 score in the patients undergoing OT was good. At six months, the DAS28 score and patient’s general health were 2.2±1.0 and 0.95±1.3 in the patients undergoing OT, and 2.1±0.78 and 0.88±0.95 in the other patients, respectively.

Conclusion: Combination therapy with medications and rehabilitation was effective in the early phase in patients with early RA.