関節リウマチにおける生物学的製剤切り替え時に即効性を引き出す手法：K-methodの有効性

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  • A Method to Acquire Early Efficacy in Switching Biologic Agents in Rheumatoid Arthritis – The K-method
  • カンセツ リウマチ ニ オケル セイブツガクテキ セイザイ キリカエ ジ ニ ソッコウセイ オ ヒキダス シュホウ : K-method ノ ユウコウセイ

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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.<br>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.<br>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.<br>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.

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