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Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infliximab therapy in patients with rheumatoid arthritis

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この文献へのリンクには次のURLを使用してください:http://hdl.handle.net/2115/62831

タイトル: Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infliximab therapy in patients with rheumatoid arthritis
著者: Takeuchi, Tsutomu 著作を一覧する
Miyasaka, Nobuyuki 著作を一覧する
Tatsuki, Yoshihiko 著作を一覧する
Yano, Toshiro 著作を一覧する
Yoshinari, Toru 著作を一覧する
Abe, Tohru 著作を一覧する
Koike, Takao 著作を一覧する
発行日: 2011年 7月
出版者: BMJ Publishing Group
誌名: Annals of the Rheumatic Diseases
巻: 70
号: 7
開始ページ: 1208
終了ページ: 1215
出版社 DOI: 10.1136/ard.2011.153023
抄録: Objectives: To investigate the possible role of baseline plasma tumour necrosis factor alpha levels (baseline-TNF) on the clinical response to infliximab in patients with rheumatoid arthritis (RA). Methods: Patients with RA refractory to methotrexate received 3, 6, or 10 mg/kg of infliximab every 8 weeks, in a randomised, double-blind manner: the RISING study. Clinical response (disease activity score in 28 joints based on C-reactive protein or American College of Rheumatology core set) at week 54 and serum infliximab levels were compared in three patient groups with low, intermediate, or high baseline-TNF (TNF-low, TNF-int, or TNF-high). Results: In TNF-low patients, the clinical response to different doses of infliximab was comparable, whereas TNF-int patients exhibited a dose-dependent trend. In contrast, TNF-high patients (approximately 13% of the total patients) had a clinical response to 10 mg/kg significantly better than the response to 3 and 6 mg/kg of infliximab. In TNF-high patients, the median trough serum levels of infliximab were below the detection limit (<0.1 μg/ml) at 3 and 6 mg/kg but were greater than 2 μg/ml at 10 mg/kg, whereas the levels were approximately 1 μg/ml for each dosage group in TNF-low patients. Conclusion: In patients with RA, baseline-TNF is significantly associated with the clinical response to infliximab in patients with a high baseline-TNF. A higher dose of infliximab may be necessary in these patients, whereas lower doses of infliximab are sufficient for those with a low baseline-TNF. Baseline-TNF may be a useful measure for personalising the treatment of RA using infliximab.
Rights: This article has been accepted for publication in Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infl iximab therapy in patients with rheumatoid arthritis, Tsutomu Takeuchi, Nobuyuki Miyasaka, Yoshihiko Tatsuki, Toshiro Yano, Toru Yoshinari, Tohru Abe and Takao Koike, Ann Rheum Dis, 2011, 70(7), pp.1208-1215, following peer review and can also be viewed on the journal's website at ard.bmj.com.
資料タイプ: article
URI: http://hdl.handle.net/2115/62831
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 小池 隆夫

 

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