関節リウマチに対するインフリキシマブによる薬剤不要寛解

• Published in: 臨床リウマチ Vol. 21; no. 3; pp. 212 - 218
• Main Authors: 鈴木, 祐孝, 井上, 靖雄, 神戸, 克明, 千葉, 純司, 早田, 浩一朗, 中村, 篤司
• Format: Journal Article
• Language: Japanese
• Published: 一般社団法人 日本臨床リウマチ学会 2009; The Japanese Society for Clinical Rheumatology and Related Research
• Subjects: drug-free; infliximab; remission; rheumatoid arthritis
• ISSN: 0914-8760; 2189-0595
• DOI: 10.14961/cra.21.212

    To analyze drug-free remission cases after treatment with infliximab, we investigated 21 remission cases out of 135 patients with established RA who had discontinued use of infliximab. Infliximab was discontinued when a negative CRP and negative MMP-3, below 2.6 points of DAS28, were continuously obtained for more than 6 months. Out of 135 patients, 40%(54/135) were in remission, 38.8%(21/54) stopped infliximab for remission, and 19%(4/21) showed drug-free remission among the patients stopped infliximab by remission. Drug-free remission which does not need all medical drugs including biologics, MTX, PSL, DMARDS and NSAIDS is different from clinical remission in terms of the definition. The continuous rate of remission after stopping infliximab was 66% at1years, by the Kaplan-Meier method. Of the four cases, no case showed increased CRP levels 18 months after discontinuing infliximab showing drug-free remission. Average disease duration of drug-free cases was 21.25 months. The MMP-3 levels and RAPA showed low level before and after drug-free remission. Therefore, the patients of early RA can accomplish drug-free remission by using infliximab before increasing MMP-3 and RAPA.