10\u670817\u65e5\u6771\u4eac\u3067\u884c\u308f\u308c\u307e\u3057\u305f\u7b2c5\u4f1aRA\u3068IL-6\u7814\u7a76\u4f1a\u306b\u53c2\u52a0\u3057\u307e\u3057\u305f\u3002<\/p>\n
\u6700\u8fd1\u3067\u306f\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u7d04\u534a\u5206\u304c\u5bdb\u89e3\u306b\u5c0e\u5165\u3067\u304d\u308b\u69d8\u306b\u306a\u3063\u3066\u304d\u305f\u3002\u5bdb\u89e3\u306e\u5f8c\u306f\u3069\u3046\u3059\u308b\u304b\u304c\u4eca\u5f8c\u306e\u8ab2\u984c\u3067\u3042\u308b\u3002\u5bdb\u89e3\u7dad\u6301\u304c\u3067\u304d\u306a\u304f\u306a\u308b\u306e\u306f\u3001DAS28\u3001\u5bdb\u89e3\u7dad\u6301\u4e2d\u306eMTX\u306e\u6e1b\u91cf\u304c\u56e0\u5b50\u3068\u3057\u3066\u3042\u3052\u3089\u308c\u308b\u3002\u30d0\u30a4\u30aa\u4f7f\u7528\u4e2d\u3067\u3001\u30b9\u30c6\u30ed\u30a4\u30c9\u4e2d\u6b62\u3001MTX\u4e2d\u6b62\u3067\u3082\u5bdb\u89e3\u7dad\u6301\u306b\u306f\u5f71\u97ff\u304c\u306a\u3044\u3002\u3080\u3057\u308d\u3001\u30b9\u30c6\u30ed\u30a4\u30c9\u4e2d\u6b62\u7fa4\u3084MTX\u4e2d\u6b62\u7fa4\u306e\u65b9\u304c\u30d0\u30a4\u30aa\u306e\u7d99\u7d9a\u7387\u304c\u9ad8\u3044\u3002\u4e16\u754c\u7684\u306b\u898b\u308b\u3068\u3001\u7d0430%\u306f\u30d0\u30a4\u30aa\u3092\u30e2\u30ce\u30c6\u30e9\u30d4\u30fc\u3067\u4f7f\u7528\u3057\u3066\u3044\u308b\u3002\u30d0\u30a4\u30aa\u30d5\u30ea\u30fc\u306b\u3064\u3044\u3066\u306f\u3001\u7d04\u534a\u6570\u306f1\u5e74\u9593\u4e2d\u6b62\u7d99\u7d9a\u3067\u304d\u3066\u3044\u308b\u304c\u3001\u305d\u306e\u5f8c\u306b\u3064\u3044\u3066\u306f\u5341\u5206\u306a\u60c5\u5831\u304c\u306a\u3044\u3002\u6295\u4e0e\u9593\u9694\u306e\u5ef6\u9577\u3082\u9078\u629e\u80a2\u3068\u3057\u3066\u8003\u3048\u3089\u308c\u308b\u3002RA\u306e\u9aa8\u6298\u6570\u306f\u6e1b\u3063\u3066\u3044\u306a\u3044\u3002\u690e\u4f53\u9aa8\u6298\u306f\u3001\u9ad8\u9f62\u3001JHAQ\u9ad8\u5024\u3001\u30b9\u30c6\u30ed\u30a4\u30c9\u670d\u7528\u3001\u5927\u817f\u9aa8\u8fd1\u4f4d\u90e8\u9aa8\u6298\u306f\u3001\u5e74\u9f62\u3001JHAQ\u9ad8\u5024\u3001TKA\u306e\u6709\u7121\u304c\u8981\u56e0\u3068\u3057\u3066\u3042\u3052\u3089\u308c\u308b\u3002\u5165\u9662\u52a0\u7642\u3068\u306a\u308b\u7406\u7531\u3068\u3057\u3066\u306f\u3001\u547c\u5438\u5668\u611f\u67d3\u75c7\u3001\u9aa8\u6298\u306a\u3069\u304c\u3042\u3052\u3089\u308c\u308b\u3002<\/p>\n
\u30a2\u30af\u30c6\u30e0\u30e9\u76ae\u4e0b\u6ce8\u4f7f\u7528\u6210\u7e3e\u306b\u3064\u3044\u3066\u306f\u3001\u70b9\u6ef4\u88fd\u5264\u3068\u5927\u304d\u306a\u5dee\u306f\u306a\u304f\u3001\u6d88\u5316\u7ba1\u7a7f\u5b54\u3084\u5fc3\u4e0d\u5168\u306b\u3064\u3044\u3066\u306f\u30011\u5e74\u76ee\u306b\u3084\u3084\u591a\u304f\u898b\u3089\u308c\u305f\u304c\u3001\u5897\u52a0\u3059\u308b\u3053\u3068\u306f\u306a\u304b\u3063\u305f\u3002<\/p>\n
csDMARD\u306e\u4f7f\u7528\u6cd5\u3068\u3057\u3066\u3001\u30de\u30a4\u30b3\u30d0\u30af\u30c6\u30ea\u30a6\u30e0\u30a2\u30d6\u30bb\u30b9\u306e\u6642\u3067\u3082\u3001\u514d\u75ab\u6291\u5236\u306e\u306a\u3044\u30a4\u30b0\u30e9\u30c1\u30e2\u30c9\u306f\u4f7f\u7528\u53ef\u80fd\u3067\u3042\u308a\u3001\u900f\u6790\u60a3\u8005\u3067\u3082\u4f7f\u7528\u53ef\u80fd\u3067\u3042\u308b\u3002MTX\u4f7f\u7528\u3067\u304d\u306a\u3044\u75c7\u4f8b\u3067\u306ecsDMARD\u3068\u3057\u3066\u306f\u30a4\u30b0\u30e9\u30c1\u30e2\u30c9\u304c\u3088\u3044\u306e\u3067\u306f\u306a\u3044\u304b\uff1f\u30d0\u30a4\u30aa\u52b9\u679c\u4e0d\u5341\u5206\u4f8b\u306b\u30a4\u30b0\u30e9\u30c1\u30e2\u30c9\u3092\u8ffd\u52a0\u4f75\u7528\u3059\u308b\u3053\u3068\u306b\u3088\u308a\u5bdb\u89e3\u5c0e\u5165\u304c\u53ef\u80fd\u3068\u306a\u308b\u3053\u3068\u304c\u3042\u308b\u3002\u30d0\u30a4\u30aa\u30ec\u30b9\u30ad\u30e5\u30fc\u306b\u306f\u30bf\u30af\u30ed\u30ea\u30e0\u30b9\u304c\u6709\u52b9\u3067\u3042\u308b\u3002\u30c8\u30e9\u30d5\u5024\u304c\u9ad8\u3044\u3068DAS\u5bdb\u89e3\u7387\u304c\u9ad8\u3044\u3002\u30d0\u30a4\u30aa\u30d5\u30ea\u30fc\u3068\u30d0\u30a4\u30aa\u30ec\u30b9\u30ad\u30e5\u30fc\u306b\u306f\u30bf\u30af\u30ed\u30ea\u30e0\u30b9\u304c\u6709\u52b9\u3067\u3042\u308b\u3002\u30d0\u30a4\u30aa\u30d5\u30ea\u30fc\u3092\u5c0e\u5165\u3059\u308b\u306b\u3042\u305f\u3063\u3066\u306f\u3001csDMARD\u30923\u5264\u4f75\u7528\u3059\u308b\u3053\u3068\u306b\u3088\u308a\u9054\u6210\u3057\u3084\u3059\u3044\u3002ENT\u304b\u3089TCZ\u3078\u306e\u30b9\u30a4\u30c3\u30c1\u306e\u6642\u306b\u3001TCZ\u306e\u52b9\u679c\u767a\u63ee\u307e\u3067\u306e\u30bf\u30a4\u30e0\u30e9\u30b0\u304c\u3042\u308a\u3001\u305d\u306e\u3068\u304d\u306bPSL\u3092\u77ed\u671f\u8ffd\u52a0\u3059\u308b\u3068\u6709\u52b9\u3067\u3042\u308b\u3002<\/p>\n
2016 EULRA recommendation\u306b\u304a\u3044\u3066\u3001MTX-IR\u3067\u306f\u4e88\u5f8c\u4e0d\u826f\u56e0\u5b50\u304c\u3042\u308c\u3070\u3001bDMARD\u3082\u3057\u304f\u306fJAK\u963b\u5bb3\u85ac\u304c\u63a8\u5968\u3055\u308c\u3066\u3044\u308b\u3002ADACT study\u3067\u306f\u3001MTX-intolerance \u306b\u304a\u3044\u3066TCZ\u304cADA\u3088\u308a\u3082\u6709\u52b9\u6027\u304c\u9ad8\u3044\u3053\u3068\u304c\u793a\u3055\u308c\u305f\u3002\u65e5\u672c\u306eSURPRISE study\u3067\u306f\u3001MTX-IR\u306b\u5bfe\u3057\u3066\u3001TCZ\u3092add-on\u7fa4\u3068TCZ\u3078\u306eswitch\u7fa4\u3067\u6bd4\u8f03\u3059\u308b\u3068\u30016\u30f6\u6708\u5f8c\u306e\u5bdb\u89e3\u306fadd-on\u306770%\u3001awitch\u306755%\u30021\u5e74\u3067\u306f\u3053\u306e\u5dee\u304c\u306a\u304f\u306a\u308a\u30ad\u30e3\u30c3\u30c1\u30a2\u30c3\u30d7\u3055\u308c\u308b\u3002mTSS\u3067\u898b\u308b\u3068\u3001\u69cb\u9020\u7684\u5bdb\u89e3\u306f66%\u306864%\u3001\u60aa\u5316\u3057\u305fCRRP\u306f7%\u306815%\u3067\u3042\u308a\u3001add-on\u306e\u65b9\u304c\u69cb\u9020\u7684\u304b\u3093\u304b\u3093\u3092\u9054\u6210\u3057\u3084\u3059\u3044\u3002\u3057\u304b\u3057\u3001\u526f\u4f5c\u7528\u306fadd-on\u7fa4\u306e\u65b9\u304cawitch\u7fa4\u3088\u308a\u3082\u591a\u304f\u3001MTX\u3092\u4e2d\u6b62\u3059\u308b\u65b9\u304c\u5b89\u5168\u6027\u306f\u9ad8\u3044\u3002\u4ee5\u4e0a\u304b\u3089\u3001MTX-IR\u3067\u306f\u30016\u30f6\u6708\u9593\u306fTCZ\uff0bMTX\u3067\u6cbb\u7642\u3057\u3001\u5bdb\u89e3\u304c\u5c0e\u5165\u3055\u308c\u308c\u3070MTX\u3092\u4e2d\u6b62\u3059\u308b\u306e\u304c\u3088\u3044\u3068\u601d\u308f\u308c\u308b\u3002csDMARD\u304c\u4f75\u7528\u3067\u304d\u306a\u3044\u60a3\u8005\u3067\u306e\u30d0\u30a4\u30aa\u306f\u3001IL-6\u963b\u5bb3\u85ac\u3068JAC\u963b\u5bb3\u85ac\u304c\u30a2\u30c9\u30d0\u30f3\u30c6\u30fc\u30b8\u304c\u3042\u308b\u3002TNF-failure\u306b\u5bfe\u3059\u308b\u6b21\u306e\u30d0\u30a4\u30aa\u306f\uff1f2nd\u30d0\u30a4\u30aa\u306f\u3001TNF\u88fd\u5264\u3088\u308a\u3082\u3001non-TNF\u88fd\u5264\u306e\u65b9\u304c\u6709\u52b9\u6027\u304c\u9ad8\u3044\u3002\u73fe\u6642\u70b9\u3067\u306e\u7b2c\u4e00DMARD\u306f\uff1fU-Act-Eary study\u3067\u306f\u300180-90%\u304c\u611f\u6168\u306b\u5c0e\u5165\u3055\u308c\u3001TCZ\uff0bMTX\u3001TCZ\u5358\u72ec\u306f\u3001MTX\u5358\u72ec\u3088\u308a\u3082\u6709\u52b9\u6027\u304c\u9ad8\u3044\u3002TCZ\u5358\u72ec\u306f\u3001TCZ\uff0bMTX\u3068\u307b\u307c\u540c\u7b49\u3067\u3042\u308b\u3002\u533b\u7642\u7d4c\u6e08\u3092\u8003\u3048\u306a\u3051\u308c\u3070\u3001\u5168\u4f8b\u30d0\u30a4\u30aa\u3067\u30b9\u30bf\u30fc\u30c8\u3059\u308b\u306e\u304c\u30d9\u30b9\u30c8\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"
10\u670817\u65e5\u6771\u4eac\u3067\u884c\u308f\u308c\u307e\u3057\u305f\u7b2c5\u4f1aRA\u3068IL-6\u7814\u7a76\u4f1a\u306b\u53c2\u52a0\u3057\u307e\u3057\u305f\u3002 \u6700\u8fd1\u3067\u306f\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u7d04\u534a\u5206\u304c\u5bdb\u89e3\u306b\u5c0e\u5165\u3067\u304d\u308b\u69d8\u306b\u306a\u3063\u3066\u304d\u305f\u3002\u5bdb\u89e3\u306e\u5f8c\u306f\u3069\u3046\u3059\u308b\u304b\u304c\u4eca\u5f8c\u306e\u8ab2\u984c\u3067\u3042\u308b\u3002\u5bdb\u89e3\u7dad\u6301\u304c\u3067\u304d\u306a\u304f\u306a\u308b\u306e\u306f\u3001DAS28\u3001\u5bdb\u89e3 […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-212","post","type-post","status-publish","format-standard","hentry","category-1"],"_links":{"self":[{"href":"https:\/\/otanaika-clinic.com\/information\/index.php?rest_route=\/wp\/v2\/posts\/212","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/otanaika-clinic.com\/information\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/otanaika-clinic.com\/information\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/otanaika-clinic.com\/information\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/otanaika-clinic.com\/information\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=212"}],"version-history":[{"count":1,"href":"https:\/\/otanaika-clinic.com\/information\/index.php?rest_route=\/wp\/v2\/posts\/212\/revisions"}],"predecessor-version":[{"id":213,"href":"https:\/\/otanaika-clinic.com\/information\/index.php?rest_route=\/wp\/v2\/posts\/212\/revisions\/213"}],"wp:attachment":[{"href":"https:\/\/otanaika-clinic.com\/information\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=212"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/otanaika-clinic.com\/information\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=212"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/otanaika-clinic.com\/information\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=212"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}