Vol.18 No.5

Original Article

Retrospective clinical study on the notable efficacy and related factors of infliximab therapy in a rheumatoid arthritis management group in Japan: one-year outcome of joint destruction (RECONFIRM-2J)

Authors

Tsutomu Takeuchi1, Hisashi Yamanaka3, Eisuke Inoue3, Hayato Nagasawa1, Masao Nawata2, Katsunori Ikari3, Kazuyoshi Saito2, Naoya Sekiguchi1, Eri Sato3, Hideto Kameda1, Shigeru Iwata2, Takeshi Mochizuki3, Kouichi Amano2 and Yoshiya Tanaka2

  1. Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, 1981 Tsujido-machi, Kamoda, Kawagoe Saitama, 350-8550, Japan
  2. The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
  3. Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
Received:

11 March 2008

Accepted:

21 March 2008

Published online:

21 May 2008

Full Text

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Abstract

The anti-TNF-α chimeric monoclonal antibody infliximab is the first biologic to be approved for rheumatoid arthritis (RA) in Japan, and post-marketing surveillance of all of the Japanese cases treated with infliximab has been conducted to explore the safety of infliximab therapy. In addition, a retrospective clinical study on the notable efficacy and related factors of infliximab therapy in an RA management group in Japan (RECONFIRM and RECONFIRM-2) has demonstrated clinical responses. However, information on the effect of infliximab on joint destruction in Japanese RA patients remains insufficient. In this study, we retrospectively analyzed X-ray data from 67 patients in whom both hand and foot X-rays at baseline and at 54 weeks had been available among the 410 cases in the RECONFIRM-2 study. By scoring the X-rays according to the modified van der Heijde (vdH)-Sharp method, we found that the total vdH-Sharp score in the RA patients before infliximab therapy was 104.40 ± 87.34 and the yearly progression was 21.33, indicating relatively rapid progression. After infliximab therapy for 54 weeks, the total vdH-Sharp score at 54 weeks was 104.37 ± 86.87 and the estimated yearly progression was -0.03, indicating the almost complete inhibition of progression. The RECONFIRM-2J study confirmed the significant ability of infliximab to halt joint destruction in Japanese RA patients, and showed that joint destruction was significantly associated with disease activity and the dose of MTX in the patients with moderate and advanced disease durations, respectively, before infliximab therapy.

Key words

Rheumatoid arthritis - Infliximab - Total van der Heijde-Sharp score - Joint destruction