研究者詳細 - 竹内　勤

論文 - 竹内　勤

分割表示 514 件中 321 - 340 件目／全件表示 >>

Clinical significance of cartilage biomarkers for monitoring structural joint damage in rheumatoid arthritis patients treated with anti-TNF therapy

Niki Y., Takeuchi T., Nakayama M., Nagasawa H., Kurasawa T., Yamada H., Toyama Y., Miyamoto T.

PLoS ONE （PLoS ONE） 7 （ 5 ） 2012年05月

研究論文（学術雑誌）, 共著, 査読有り

Purpose: With the current use of biologics in rheumatoid arthritis (RA), there is a need to monitor ongoing structural joint damage due to the dissociation of articular cartilage damage from disease activity of RA. This study longitudinally analyzed levels of serum cartilage biomarkers during 54 weeks of infliximab therapy, to evaluate the feasibility of biomarkers for monitoring structural joint damage. Methods: Subjects comprised 33 patients with early RA and 33 patients with established RA. All patients received 3 mg/kg of infliximab and methotrexate for 54 weeks. Levels of the following serum cartilage markers were measured at baseline and at weeks 14, 22, and 54: hyaluronan (HA); cartilage oligometric matrix protein (COMP); type II collagen (CII)-related neoepitope (C2C); type II procollagen carboxy-propeptide (CPII); and keratin sulfate (KS). Time courses for each biomarker were assessed, and relationships between these biomarkers and clinical or radiographic parameters generally used for RA were investigated. Results: Levels of CRP, MMP-3, DAS28-CRP, and annual progression of TSS were improved to similar degrees in both groups at week 54. HA and C2C/CPII were significantly decreased compared to baseline in the early RA group (p&0.001), whereas HA and COMP, but not C2C/CPII, were decreased in the established RA group. Strikingly, serum C2C/CPII levels were universally improved in early RA, regardless of EULAR response grade. Both ΔHA and ΔC2C/CPII from baseline to week 54 correlated significantly with not only ΔCRP, but also ΔDAS28 in early RA. Interestingly, when partial correlation coefficients were calculated by standardizing CRP levels, the significant correlation of ΔHA to ΔDAS28 disappeared, whereas correlations of ΔC2C/CPII to ΔDAS28, ΔJNS, and ΔHAQ remained significant. These results suggest a role of ΔC2C/CPII as a marker of ongoing structural joint damage with the least association with CRP, and that irreversible cartilage damage in established RA limits restoration of the C2C/CPII level, even with tight control of joint inflammation. Conclusion: The temporal course of C2C/CPII level during anti-TNF therapy indicates that CII turnover shifts toward CII synthesis in early RA, but not in established RA, potentially due to irreversible cartilage damage. ΔC2C/CPII appears to offer a useful marker reflecting ongoing structural joint damage, dissociated from inflammatory indices such as CRP and MMP-3. © 2012 Niki et al.

Access to Document (DOI)

Lansoprazole for secondary prevention of gastric or duodenal ulcers associated with long-term non-steroidal anti-inflammatory drug (NSAID) therapy: Results of a prospective, multicenter, double-blind, randomized, double-dummy, active-controlled trial

竹内勤

Journal of Gastroenterology （Journal of Gastroenterology） 47 （ 5 ） 540 - 552 2012年05月

研究論文（学術雑誌）, 査読有り, ISSN 0944-1174

Background Low-dose lansoprazole has not been intensively evaluated for its efficacy in the prevention of recurrent gastric or duodenal ulcers in patients receiving long-term non-steroidal anti-inflammatory drug (NSAID) therapy for pain relief in such diseases as rheumatoid arthritis, osteoarthritis, and low back pain. Methods This multi-center, prospective, double-blind, randomized, active-controlled study involving 99 sites in Japan was designed to compare the efficacy of lansoprazole (15 mg daily) with gefarnate (50 mg twice daily). Patients with a history of gastric or duodenal ulcers who required long-term NSAID therapy were randomized to receive lansoprazole 15 mg daily (n = 185) or gefarnate 50 mg twice daily (n = 181) and followed up for 12 months or longer prospectively. Results The cumulative incidence of gastric or duodenal ulcer at days 91, 181, and 361 from the start of the study was calculated by the Kaplan-Meier method as 3.3, 5.9, and 12.7%, respectively, in the lansoprazole group versus 18.7, 28.5, and 36.9%, respectively, in the gefarnate group. The risk for ulcer development was significantly (log-rank test, P<0.0001) lower in the lansoprazole group than in the gefarnate group, with the hazard ratio being 0.2510 (95% CI 0.1400-0.4499). A long-term follow-up study showed an acceptable safety profile for low-dose lansoprazole therapy, with diarrhea as the most frequent adverse event. Conclusion Lansoprazole was superior to gefarnate in reducing the risk of gastric or duodenal ulcer recurrence in patients with a definite history of gastric or duodenal ulcers who required long-term NSAID therapy. © 2012 Springer.

Access to Document (DOI)

CD3 ζ defects in systemic lupus erythematosus.

Takeuchi Tsutomu, Suzuki Katsuya, Kondo Tsuneo, Yoshimoto Keiko, Tsuzaka Kensei

Annals of the Rheumatic Diseases 71 Suppl 2 2012年04月

研究論文（学術雑誌）, 共著, 査読有り

The prototype autoimmune disease, systemic lupus erythematosus (SLE), has been known to be associated with deficiency of ζ chain, a component of the T-cell receptor-CD3 complex. Comprehensive analysis has shown that expression of the CD3 ζ chain is attenuated or absent in over half of SLE patients. Furthermore, aberrant transcripts of the CD3 ζ chain, including spliced variants lacking exon 7 or having a short 3'-untranslated region, have been detected in SLE T cells. Although attenuated expression of the CD3 ζ chain is also observed in cancer patients, infections and other autoimmune diseases, sustained attenuation of the CD3 ζ expression accompanied with aberrant transcripts are only observed in SLE. In this study, the authors review the unique features of CD3 ζ defects observed in SLE and discuss the molecular basis of the defects by recent findings in animal models, single-nucleotide polymorphisms and genome-wide association studies.

Clinicopathological analyses in patients with other iatrogenic immunodeficiency-associated lymphoproliferative diseases and rheumatoid arthritis

竹内勤

Leukemia and Lymphoma （Leukemia and Lymphoma） 53 （ 4 ） 616 - 623 2012年04月

研究論文（学術雑誌）, 査読有り, ISSN 1042-8194

Despite numerous attempts to uncover the mechanism of other iatrogenic immunodeficiency-associated lymphoproliferative diseases (OIIA-LPDs), this mechanism remains poorly understood, especially in rheumatoid arthritis (RA) patients. We analyzed the data on 23 patients with LPDs and RA. Patients were categorized into three groups according to whether they had methotrexate (MTX); MTX-regressive LPDs, MTX-persistent LPDs or other drugs-mediated LPDs. The LPDs seen in OIIA-LPDs-RA might have a unique behavior to think about several rare phenotypes. The overall survival of all patients was 74% at 5 years, and those of the three groups were 100%, 64% and 60%, respectively. Among the 6 patients who died, 4 had LPDs that were detected late, and thus adequate treatment was not given. In addition, several patients with diffuse large B cell lymphoma with a complex karyotype achieved complete remission (CR). Only one among the 17 patients who achieved CR relapsed. OIIA-LPDs-RA appeared to have a better prognosis than other more common types of lymphomas. Regarding RA treatment, various anti-RA drugs were given to the patients after developing LPDs, including MTX, but no recurrent patients were documented. © 2012 Informa UK, Ltd.

Access to Document (DOI)

Critical role of CD4+CD25+ regulatory T cells in preventing murine autoantibody-mediated thrombocytopenia

竹内勤

Experimental Hematology （Experimental Hematology） 40 （ 4 ） 279 - 289 2012年04月

研究論文（学術雑誌）, 査読有り, ISSN 0301-472X

Autoimmune response suppression by regulatory T cells (Tregs) helps to maintain peripheral immune tolerance, and defects in this mechanism are thought to play a role in the pathogenesis of various autoimmune diseases. In patients with immune thrombocytopenia, naturally occurring CD4+CD25+ Tregs are both functionally impaired and reduced in number. This study was undertaken to investigate Tregs' role in preventing immune thrombocytopenia in mice. Treg-deficient mice were prepared by inoculation of Treg-depleted CD4+CD25- T cells isolated from BALB/c mice into syngeneic nude mice intravenously. Platelet count, proportion of reticulated platelets, platelet-associated IgG, platelet-associated anti-platelet antibodies, and IgG anti-platelet antibody production in splenocyte cultures were examined by flow cytometry. Of 69 Treg-deficient mice, 25 (36%) spontaneously developed thrombocytopenia that lasted at least 5 weeks. The platelet-associated IgG level and proportion of reticulated platelets were elevated in the thrombocytopenic mice. Platelet eluates and splenocyte culture supernatants prepared from thrombocytopenic mice, but not from nonthrombocytopenic mice, contained IgG antibodies capable of binding to intact platelets. Simultaneous transfer of Tregs completely prevented the onset of thrombocytopenia, but Treg transfer after the onset of thrombocytopenia had no apparent effect. Treatment with IgG anti-cytotoxic T lymphocyte-associated antigen 4 antibody canceled this Treg-governed suppressive effect. In summary, these results indicate that Tregs play a critical role in preventing murine autoantibody-mediated thrombocytopenia by engaging cytotoxic T lymphocyte-associated antigen 4. © 2012 ISEH - Society for Hematology and Stem Cells.

Access to Document (DOI)

CD3 ξ defects in systemic lupus erythematosus

Takeuchi T., Suzuki K., Kondo T., Yoshimoto K., Tsuzaka K.

Annals of the Rheumatic Diseases （Annals of the Rheumatic Diseases） 71 （ SUPPL. 2 ） i78 - i81 2012年04月

研究論文（学術雑誌）, 査読有り, ISSN 0003-4967

The prototype autoimmune disease, systemic lupus erythematosus (SLE), has been known to be associated with deficiency of ξ chain, a component of the T-cell receptor-CD3 complex. Comprehensive analysis has shown that expression of the CD3 ξ chain is attenuated or absent in over half of SLE patients. Furthermore, aberrant transcripts of the CD3 ξ chain, including spliced variants lacking exon 7 or having a short 3′-untranslated region, have been detected in SLE T cells. Although attenuated expression of the CD3 ξ chain is also observed in cancer patients, infections and other autoimmune diseases, sustained attenuation of the CD3 ξ expression accompanied with aberrant transcripts are only observed in SLE. In this study, the authors review the unique features of CD3 ξ defects observed in SLE and discuss the molecular basis of the defects by recent findings in animal models, single-nucleotide polymorphisms and genome-wide association studies.

Access to Document (DOI)

Structural damages disturb functional improvement in patients with rheumatoid arthritis treated with etanercept

Tanaka Y., Yamanaka H., Saito K., Iwata S., Miyagawa I., Seto Y., Momohara S., Nagasawa H., Kameda H., Kaneko Y., Izumi K., Amano K., Takeuchi T.

Modern Rheumatology （Modern Rheumatology） 22 （ 2 ） 186 - 194 2012年04月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1439-7595

Tumor necrosis factor (TNF) inhibitors have produced improvements in clinical, radiographic, and functional outcomes in rheumatoid arthritis (RA) patients. However, it remains unclear whether factors affecting physical functions remain following TNF therapy. The objective of our study was to assess factors affecting improvement of physical functions and to shed light on relations to disease activity and structural changes in patients with RA treated with etanercept. The study enrolled 208 patients, all of whose composite measures regarding clinical, radiographic, and functional estimation both at 0 and 52 weeks after etanercept therapy were completed. Mean disease duration of 208 patients was 9.6 years, mean Disease Activity Score for 28 joints (DAS28) was 5.4, and mean van der Heijde modified total Sharp score (mTSS) was 94.6. Mean Health Assessment Questionnaire Disability Index (HAQ-DI) improved from 1.4 at 0 weeks to 1.0 at 52 weeks after etanercept therapy, a 31% reduction, which was much less than changes in DAS28 and mTSS. By multivariate analysis, HAQ-DI and mTSS at baseline were significantly correlated HAQ remission. Median HAQ-DI improved in 100 versus 20% of the HAQ-DI ≤0.6 versus ≥2.0 groups, respectively. The mTSS cutoff point at baseline to obtain HAQ remission was 55.5. During etanercept treatment in the mTSS <55.5 versus >55.5 groups, median HAQ-DI improved in 70 versus 39%; remission was achieved in 59 versus 33%; and there was no improvement in 14 versus 30%, respectively. HAQ-DI improvement was significantly correlated with that of DAS28 but not of mTSS. In conclusion, higher HAQ and mTSS at baseline inhibits HAQ-DI improvement within 1 year of etanercept treatment, and the cutoff point necessary for mTSS to improve physical functions in patients with RA was 55.5. © Japan College of Rheumatology 2011.

Access to Document (DOI)

What is the future of CCR5 antagonists in rheumatoid arthritis?

Takeuchi Tsutomu, Kameda Hideto

Arthritis Research and Therapy 14 （ 2 ） R11 2012年03月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1478-6354

Fleishaker and colleagues reported on a double-blind placebo controlled clinical trial of a C-C chemokine-receptor type 5 (CCR5) antagonist, maraviroc, in rheumatoid arthritis (RA) patients with inadequate response to methotrexate, showing that it was ineffective. Two additional CCR5 antagonists, SCH351125 and AZD5672, also failed to demonstrate clinical efficacy. In addition, CCR5-blocking antibodies could not inhibit synovial fluid-induced monocyte chemotaxis. Thus, CCR5 appears not to be a desirable target in RA treatment. Given the multiple functions of CCR5, redundancies in the chemokine system, and patient selection in the trial, we overview the recent understanding for chemokine receptor blockade in the treatment of RA. © 2012 BioMed Central Ltd.

Access to Document (DOI)

[The 39th scientific meeting: perspectives of internal medicine; the cutting edge of treatment of medical disorders encountered in clinical practice; 9. Progress in RA management].

Takeuchi T.

Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine （Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine） 101 （ 3 ） 647 - 653 2012年03月

研究論文（学術雑誌）, 査読有り, ISSN 00215384

Successful treatment of adult-onset Still's disease with tocilizumab monotherapy: Two case reports and literature review

Sakai R., Nagasawa H., Nishi E., Okuyama A., Takei H., Kurasawa T., Kondo T., Nishimura K., Shirai Y., Ito T., Kameda H., Takeuchi T., Amano K.

Clinical Rheumatology （Clinical Rheumatology） 31 （ 3 ） 569 - 574 2012年03月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0770-3198

Adult-onset Still's disease (AOSD) is a systemic inflammatory disease of unknown etiology. Recently, it has been reported that quite a few cases of refractory AOSD were successfully treated with tocilizumab (TCZ) and corticosteroids were withdrawn in some of these patients. We report two AOSD patients who were treated successfully with TCZ monotherapy; thus, avoiding corticosteroid treatment. Because both of the patients refused to take corticosteroids, we planned to treat them with 8 mg/kg of TCZ monotherapy at weeks 0, 2, 6 and subsequently every 4 weeks. The efficacy of TCZ was assessed by patients' clinical symptoms such as fever, arthralgia, skin eruptions, and laboratory markers such as serum levels of CRP, ferritin, and IL-6. We also reviewed 14 previous case reports including 30 cases who had been treated with TCZ for AOSD. Our patients responded rapidly and have been maintained in clinical remission without corticosteroid treatment. In the literature review, concomitant corticosteroid treatment described in 13 cases was successfully tapered in 7 and discontinued in 6 cases. TCZ monotherapy can be a candidate for the first-line therapy for some AOSD patients. © 2011 Clinical Rheumatology.

Access to Document (DOI)

[Clinical significance of serum cartilage biomarkers in the treatment of rheumatoid arthritis with biological therapy].

Niki Y., Takeuchi T.

Clinical calcium （Clinical calcium） 22 （ 2 ） 205 - 212 2012年02月

研究論文（学術雑誌）, 査読有り, ISSN 09175857

With the current use of biologics in RA, numerous patients can achieve clinical remission, however structural joint damage occurs in substantial numbers of the patients. The present study assessed cartilage damage during 54-week anti-TNF therapy, using serum cartilage markers, and potential advantages of these markers were evaluated. Levels of serum hyaluronan decreased with decreasing levels of CRP in both early and established RA, whereas indicator of type II collagen synthesis/degradation, C2C/CP II decreased only in early RA group. Levels of COMP and keratin sulfate significantly decreased and increased compared to baseline, respectively, by week 54 in established RA. Strikingly, C2C/CP II levels were universally improved in early RA, regardless of CRP levels or EULAR response grade. In contrast, C2C/CP II levels universally worsened in established RA, even though patients achieved good response. As a role of surrogate marker reflecting therapeutic efficacy of biological therapy, C2C/CP II appears particularly useful for determining the degree of ongoing structural joint deterioration, which is dissociated from clinical assessment of disease activity in RA.

Postmarketing surveillance of tocilizumab for rheumatoid arthritis in Japan

Koike Takao, Harigai Masayoshi, Inokuma Shigeko, Ishiguro Naoki, Ryu Junnosuke, Takeuchi Tsutomu, Takei Syuji, Tanaka Yoshiya, Ito Kyoko, Yamanaka Hisashi

Annals of the Rheumatic Diseases 70 （ 12 ） 2148 - 2151 2011年12月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0003-4967

Objective: An interim analysis of an all-patient postmarketing surveillance programme in Japan to investigate the safety of tocilizumab for the treatment of rheumatoid arthritis (RA) in the real world. Methods: This analysis included 3881 patients. Patients received 8 mg/kg of tocilizumab every 4 weeks, and were observed for 28 weeks. Data on baseline characteristics and adverse events (AE) were collected. Results: Total and serious AE were reported as 167 and 27 events/100 patient-years, respectively. The most frequent AE and serious AE were infections. Logistic regression analysis identified the following risk factors for the development of serious infection: concurrent or medical history of respiratory disorders; prednisolone dose at baseline ≥5 mg/day; and age ≥65 years. Twenty-five patients died, and the standardised mortality ratio, with the Japanese general population in 2008 as reference, was 1.66, similar to the results from the Japanese cohort study for RA patients. Conclusions: Tocilizumab is acceptably safe in the real clinical setting. Tocilizumab needs to be used with consideration of the benefit-risk balance to avoid serious infections in elderly patients and those on high doses of corticosteroids or with a concurrent or medical history of respiratory disorders.

Access to Document (DOI)

Treating rheumatoid arthritis to target

Haraoui Boulos, Smolen Josef S., Aletaha Daniel, Breedveld Ferdinand C., Burmester Gerd, Codreanu Catalin, Da Silva José Pereira, De Wit Maarten, Dougados Maxime, Durez Patrick, Emery Paul, Fonseca João Eurico, Gibofsky Allan, Gomez-Reino Juan, Graninger Winfried, Hamuryudan Vedat, Peña Maria José Jannaut, Kalden Joachim, Kvien Tore K., Laurindo Ieda, Martin-Mola Emilio, Montecucco Carlomaurizio, Moreno Pedro Santos, Pavelka Karel, Poor Gyula, Cardiel Mario H., Stanislawska-Biernat Ewa, Takeuchi Tsutomu, Van Der Heijde Désirée, Awadhi Adel Al, AlShehhi Waleed Yousef, Babic-Naglic Durda, Michel Beat A., Galarza-Maldonado Claudio, Hammoudeh Mohammed, Harrison Michael, Kolarov Zlatimir, Lee Soo Kon, Nash Peter, Otsa Kati, Sokka Tuulikki, Tate Guillermo A., Tomsic Matija, Uthman Imad, Venalis Algirdas, De Morales Sol Villegas

Annals of the Rheumatic Diseases 70 （ 11 ） 1999 - 2002 2011年11月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0003-4967

Aim: To measure the level of agreement and application of 10 international recommendations for treating rheumatoid arthritis (RA) to a target of remission/low disease activity. Methods: A 10-point Likert scale (1=fully disagree, 10=fully agree) measured the level of agreement with each of 10 recommendations. A 4-point Likert scale (never, not very often, very often, always) assessed the degree to which each recommendation was being applied in current daily practice. If respondents answered 'never' or 'not very often', they were asked whether they would change their practice according to the particular recommendation. Results: A total of 1901 physicians representing 34 countries participated. Both agreement with and application of recommendations was high. With regard to application of recommendations in daily practice, the majority of responses were 'always' and 'very often'. A significant percentage of participants who were currently not applying these recommendations in clinical practice were willing to change their practice according to the recommendations. Conclusion: The results of this survey demonstrated great support of 'Treating RA to Target' recommendations among the international rheumatology community. Additional efforts may be needed to encourage application of the recommendations among certain clinicians who are resistant to changing their practice.

Access to Document (DOI)

T Helper Type 1-Bias in a Regulatory T Cell-Deficient Mouse Model for Immune Thrombocytopenia

竹内勤

BLOOD 118 （ 21 ） 243 - 244 2011年11月

研究論文（学術雑誌）, ISSN 0006-4971

Regulatory mechanisms for the production of BAFF and IL-6 are impaired in monocytes of patients of primary Sjogren's syndrome

Yoshimoto Keiko, Tanaka Maiko, Kojima Masako, Setoyama Yumiko, Kameda Hideto, Suzuki Katsuya, Tsuzaka Kensei, Ogawa Yoko, Tsubota Kazuo, Abe Tohru, Takeuchi Tsutomu

Arthritis Research & Therapy 13 R170 2011年10月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1478-6354

Introduction: In this study, we investigated possible aberrations of monocytes from patients with primary Sjogren's syndrome (pSS). We focused on BAFF (B cell activating factor of the TNF family) and IL-6, because they are both produced by monocytes and known to be involved in the pathogenesis of pSS. Methods: Peripheral monocytes were prepared from both pSS patients and normal individuals. The cells were stimulated in vitro with IFN-gamma, and the amounts of IL-6 and sBAFF produced by the cells were quantitated. The effect of sBAFF itself on the production of IL-6 was also studied. To investigate the response of pSS monocytes to these stimuli, the expression levels of the genes encoding BAFF receptors and IL-6-regulating transcription factors were quantitated. Results: Peripheral pSS monocytes produced significantly higher amounts of sBAFF and IL-6 compared to normal monocytes, even in the absence of stimulation. The production of these cytokines was significantly increased upon stimulation with IFN-gamma. The elevated production of IL-6 was significantly suppressed by an anti-BAFF antibody. In addition, stimulation of pSS monocytes with sBAFF induced a significant increase in IL-6 production. Moreover, the expression levels of a BAFF receptor and transcription factors regulating IL-6 were significantly elevated in pSS monocytes compared to normal monocytes. Conclusions: The present study suggests that the mechanisms for the production of sBAFF and IL-6 are impaired in pSS monocytes. Our research implies that this impairment is ascribed to abnormally overexpressed IL-6-regulating transcription factors and a BAFF receptor. These abnormalities may underlie the development of pSS.

Access to Document (DOI)

Efficacy and safety of additional use of tacrolimus in patients with early rheumatoid arthritis with inadequate response to DMARDs-a multicenter, double-blind, parallel-group trial

Kawai Shinichi, Takeuchi Tsutomu, Yamamoto Kazuhiko, Tanaka Yoshiya, Miyasaka Nobuyuki

Modern Rheumatology 21 （ 5 ） 458 - 468 2011年10月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1439-7595

In this trial, we investigated the safety and efficacy of tacrolimus used in addition to standard antirheumatic drugs in patients with rheumatoid arthritis. Tacrolimus 3 mg or placebo was orally administered once daily for 52 weeks in a double-blind manner to patients with early active rheumatoid arthritis receiving other disease- modifying antirheumatic drugs (DMARDs). A total of 123 patients were randomized to the tacrolimus group (61 patients) and to the placebo group (62 patients). In the tacrolimus group, 70.5% achieved a clinical response according to American College of Rheumatology (ACR) 20 criteria, whereas 45.2% in the placebo group did so (P = 0.005). The tacrolimus group also showed significant improvement in terms of the European League Against Rheumatism (EULAR) response criteria of 'good or moderate' versus the placebo group (86.9 vs. 56.5%, respectively). Likewise, significantly more patients in the tacrolimus group versus the placebo group achieved remission of the Disease Activity Score in 28 joints (DAS28) (45 vs. 21%). The mean changes in the Total Sharp Score and erosion score were lower in the tacrolimus group, but the differences between the two groups were not significant. There was no significant difference between the two groups in the incidence of adverse events. Based on these results, we can conclude that the additional use of tacrolimus in patients with early rheumatoid arthritis with inadequate response to other DMARD treatments is useful, and this could become one of the treatment options for these rheumatoid arthritis patients. © Japan College of Rheumatology 2011.

Access to Document (DOI)

Efficacy and Safety of Certolizumab Pegol without Methotrexate Co-Administration in Japanese Patients with Active Rheumatoid Arthritis

竹内勤

ARTHRITIS AND RHEUMATISM 63 （ 10 ） S476 - S476 2011年10月

研究論文（学術雑誌）, ISSN 0004-3591

Clinical, radiographic and functional effectiveness of tocilizumab for rheumatoid arthritis patients-REACTION 52-week study

Takeuchi Tsutomu, Tanaka Yoshiya, Amano Koichi, Hoshi Daisuke, Nawata Masao, Nagasawa Hayato, Sato Eri, Saito Kazuyoshi, Kaneko Yuko, Fukuyo Shunsuke, Kurasawa Takahiko, Hanami Kentaro, Kameda Hideto, Yamanaka Hisashi

Rheumatology 50 （ 10 ） 1908 - 1915 2011年10月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1462-0324

Objectives: To evaluate the effectiveness and safety of tocilizumab in RA patients in clinical practice. Methods: We observed 232 consecutive RA patients who began tocilizumab in three rheumatology centres in Japan for 52 weeks. Clinical, radiographic and functional status and safety were evaluated. Results: Mean age of the 232 patients was 59.1 years, mean duration of disease was 12.4 years and average DAS using the 28-joint count (DAS-28) was 5.6. Although 62.8% of the patients had been treated previously with anti-TNF biologics, clinical remission at Week 52 was achieved in 43.7%, radiographic non-progression in 62.8% and functional remission in 26.4%. Retention rate at Week 52 was 71.1%, and the same for those with or without previous anti-TNF treatment. Adverse drug reactions leading to tocilizumab discontinuation were observed in 15.5% of patients, the most frequent adverse drug reaction being pneumonia in eight cases. On multivariate logistic regression analysis, DAS-28, HAQ-disability index (HAQ-DI), concomitant MTX and concomitant glucocorticoids (GCs) were predictive variables for clinical remission at Week 52 of tocilizumab treatment. In particular, HAQ-DI was found to be a predictive variable for remission of all three types-clinical, radiographic and functional-at Week 52 of tocilizumab treatment. Conclusions: In daily clinical practice, tocilizumab exhibited excellent effectiveness in established RA patients, some of whom had failed to respond to previous anti-TNF treatment. Although further detailed safety findings are required, this study provides valuable real-world findings on the management of RA with tocilizumab. © The Author 2011. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.

Access to Document (DOI)

関節リウマチの診療における労働生産性の評価の意義　より高い治療ゴールのために

竹内勤

リウマチ科 46 （ 3 ） 288 - 296 2011年09月

研究論文（学術雑誌）, 単著

関節リウマチ治療における患者版T2Tリコメンデーション

竹内勤

リウマチ科 46 （ 3 ） 297 - 302 2011年09月

研究論文（学術雑誌）

　前のページ - 次のページ　

竹内 勤

論文 - 竹内 勤

竹内　勤

論文 - 竹内　勤