3차 병원 류마티스 관절염 환자에서 항종양괴사인자 제제 치료 후 임상반응 및 관찰 평가 분석

Clinical Responses and Follow-up Evaluation after Anti-TNF Treatment in Patients with Rheumatoid Arthritis at a Tertiary-care Hospital

Rheumatoid arthritis (RA) is a chronic inflammatory disease that causes joint damage and bone erosion. Antitumor necrosis factor (anti-TNF) agents are first-line biological Disease-Modifying Anti-rheumatic Drugs (DMARDs), which can reduce the disease activity of RA. The objective of this study is to evaluate and observe the clinical responses and parameters following anti-TNF administration. We analysed the medical records of patients who were administered anti-TNF agent for RA, from September 2012 to August 2015, retrospectively. The clinical responses (ESR, CRP, swollen joint count, tender joint count) and adverse effect monitoring factors (AST, ALT, white blood cell count, hemoglobin, neutrophils count, platelet count, serum creatinine) were observed before the drug administration, and follow-up observation were also made at 3, 9, and 15-month post-administration. 104 patients of 306 patients were selected based on inclusion and exclusion criteria, and were administered etanercept (n=38), adalimumab (n=46), and infliximab (n=20). After 3 months, the clinical response significantly decreased, regardless of the type of anti-TNF agents used, and the levels were maintained up to 15 months (p<0.05). Platelet, WBC and neutrophils count decreased after 3 months of anti-TNF agent administration, regardless of the type of anti-TNF agents used, and the levels were maintained up to 15 months (p<0.05). Serum creatinine showed constant increase over the course of 15 months. Further related multi-institutional prospective studies are needed to confirm and optimize the study.