Elucidation of the mechanisms of rheumatoid arthritis flare and the importance of symptoms in it

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K09535
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Collagenous pathology/Allergology
• Research Institution: Toho University
• Principal Investigator: KAMEDA Hideto 東邦大学, 医学部, 教授 (00265795)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 関節リウマチ / 生物学的製剤 / 寛解 / 休薬 / 自覚症状 / 関節超音波 / サイトカイン

Outline of Final Research Achievements

A total of 36 patients with rheumatoid arthritis (RA) who had been in sustained remission for at least 6 months with biologic disease-modifying anti rheumatic drug (bDMARD) and preferred to discontinue bDMARD were enrolled in this study. Twenty patients developed RA flare and almost all of them returned to remission state with the re-introduction of the same bDMARD. It was difficult to predict the RA flare after bDMARD discontinuation. However, this study demonstrates that patient symptom is a sensitive measure of disease flare, blood concentration of cytokines and their receptors varies among patients receiving different bDMARDs, and interleukin-6 is the best biomarker of RA activity.

Free Research Field

膠原病、サイトカイン、分子標的治療

Academic Significance and Societal Importance of the Research Achievements

生物学的製剤の寛解休薬は医療経済学的観点からも大きなメリットがあり、関節の違和感を感じた際には早期に受診することで再燃の早期診断・早期治療が可能になり、休薬のリスクを最小化できると考えられた。さらにサイトカインおよびサイトカイン受容体の血中濃度の継時的測定結果から、患者間におけるサイトカインプロファイルの多様性と同一患者における再現性が示されたことから、テーラーメイド医療への道筋にも大きく貢献する結果となった。