Sato Eri, Tanaka Eiichi, Ochiai Moeko, Shimizu Yoko, Kobayashi Akiko, Shidara Kumi, Hoshi Daisuke, Sugimoto Naoki, Inoue Eisuke, Seto Yohei, Nakajima Ayako, Taniguchi Atsuo, Momohara Shigeki, Yamanaka Hisashi
Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan.
Mod Rheumatol. 2015 May;25(3):350-7. doi: 10.3109/14397595.2014.958274. Epub 2015 Jan 25.
BACKGROUND/PURPOSE: The use of biologic disease-modifying anti-rheumatic drugs (DMARDs) for rheumatoid arthritis (RA) has been increasing since 2003. In this study, we evaluated changes in the characteristics of patients receiving biologic DMARDs daily, in Japan.
The characteristics of all RA patients who received any biologic DMARD at the Institute of Rheumatology, Tokyo Women's Medical University, within 1 year after its approval in Japan, were retrospectively evaluated. The periods of patient enrollment for each biologic agent were: infliximab (IFX), 2003-2004; etanercept (ETN), 2005-2006; tocilizumab (TCZ), 2008-2009; adalimumab (ADA), 2008-2009; abatacept (ABT), 2010-2011; and golimumab (GLM), 2011-2012. We retrospectively collected individual patient characteristics, concomitant medication usage, and disease activity assessed by disease activity score 28 (DAS28) at the time of administration, from the medical records. The retention rate for each agent at 6 months after treatment initiation was also assessed.
The numbers of patients who received each biologic DMARD at our institute within 1 year after its approval were: IFX, 49; ETN, 50; TCZ, 62; ADA, 52; ABT, 40; and GLM, 77. From 2003 to 2012, the proportion of patients with prior use of any biologic DMARD increased, as did concomitant use and dose of methotrexate (MTX); however, corticosteroid use and doses decreased. DAS28, at the time of treatment initiation, gradually decreased. At the time of IFX administration, 75% and 25% of patients had high and moderate disease activity respectively, compared to 25% and 58% respectively, of patients who received GLM. No significant difference was observed in the retention rate of biologic DMARDs at 6 months (range, 75.0% to 89.6%).
Baseline disease activity of RA patients who received biologic DMARDs between 2003 and 2012 has changed from high to moderate in daily practice in Japan.
背景/目的：自2003年以来，用于治疗类风湿关节炎（RA）的生物性病情改善抗风湿药物（DMARDs）的使用一直在增加。在本研究中，我们评估了日本每日接受生物性DMARDs治疗的患者特征的变化。
对东京女子医科大学风湿病研究所内所有在日本批准后的1年内接受任何生物性DMARD治疗的RA患者的特征进行回顾性评估。每种生物制剂的患者入组时间为：英夫利昔单抗（IFX），2003 - 2004年；依那西普（ETN），2005 - 2006年；托珠单抗（TCZ），2008 - 2009年；阿达木单抗（ADA），2008 - 2009年；阿巴西普（ABT），2010 - 2011年；戈利木单抗（GLM），2011 - 2012年。我们从病历中回顾性收集了个体患者特征、合并用药情况以及给药时通过疾病活动评分28（DAS28）评估的疾病活动度。还评估了每种药物在治疗开始后6个月的保留率。
在我院批准后的1年内接受每种生物性DMARD治疗的患者数量分别为：IFX，49例；ETN，50例；TCZ，62例；ADA，52例；ABT，40例；GLM，77例。从2003年到2012年，先前使用过任何生物性DMARD的患者比例增加，甲氨蝶呤（MTX）的合并使用情况和剂量也增加；然而，皮质类固醇的使用和剂量减少。治疗开始时的DAS28逐渐降低。在使用IFX时，分别有75%和25%的患者具有高疾病活动度和中度疾病活动度，而接受GLM治疗的患者分别为25%和58%。生物性DMARDs在6个月时的保留率无显著差异（范围为75.0%至89.6%）。
2003年至2012年期间在日本接受生物性DMARDs治疗的RA患者的基线疾病活动度在日常实践中已从高转变为中度。
