関節リウマチ患者の肩関節における生物学的製剤の効果

概要

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The assessment of joint damage in rheumatoid arthritis (RA) during biologic therapies has been mainly restricted to small joints in hands and feet. On the other hand, there are few reports about the effects of biologics on shoulder joints in RA. The purpose of this study is to elucidate the joint damage of the shoulder and the relationship of clinical effects. Nineteen patients (2 males and 17 females, mean age of 60.0 years old) were evaluated at baseline and 2 years after biologics therapies. Clinical responses at 2 years were defined according to EULAR response criteria. The structural damage in shoulder joints was assessed using the Larsen scoring method. The medial displacement index (MI) was obtained by dividing the distance between the centre of the humeral head and the glenoid surface by the radius of the humeral head (R). The upward migration index (UI) was obtained by dividing the distance between the centre of the humeral head and the central point of the subacromial surface by R. Four of 28 shoulders of Larsen grade 0-II showed progression of each grade. Whereas 5 of 8 shoulders of Larsen III-V showed apparent progression. There was no relationship between progression of Larsen grade and clinical response. In the early grade, less than Larsen grade II, it is supposed that the progression of shoulder joint damage is inhibited.