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Treatment with Biologic Agents Improves the Prognosis of Patients with Rheumatoid Arthritis and Amyloidosis.
MedLine Citation:
PMID:  22589255     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Reactive amyloid A (AA) amyloidosis is a serious and life-threatening systemic complication of rheumatoid arthritis (RA). We evaluated the safety of therapy with anti-tumor necrosis factor and antiinterleukin 6 biologic agents in RA patients with reactive AA amyloidosis, together with prognosis and hemodialysis (HD)-free survival, in comparison with patients with AA amyloidosis without such therapy. METHODS: One hundred thirty-three patients with an established diagnosis of reactive AA amyloidosis participated in the study. Clinical data were assessed from patient records at the time of amyloid detection and administration of biologics. Survival was calculated from the date when amyloid was first demonstrated histologically or the date when biologic therapy was started until the time of death or to the end of 2010 for surviving patients. Patients who had started HD were selected for inclusion only after the presence of amyloid was demonstrated. RESULTS: Fifty-three patients were treated with biologic agents (biologic group) and 80 were not (nonbiologic group). Survival rate was significantly higher in the biologic group than in the nonbiologic group. Nine patients in the biologics group and 33 in the nonbiologic group started HD. Biologic therapy had a tendency for reduced risk of initiation of HD without any statistical significance. CONCLUSION: Patients with amyloidosis have a higher mortality rate, but the use of biologic agents can reduce risk of death. The use of biologics may not significantly influence the HD-free survival rate.
Authors:
Takeshi Kuroda; Naohito Tanabe; Daisuke Kobayashi; Hiroe Sato; Yoko Wada; Shuichi Murakami; Takako Saeki; Masaaki Nakano; Ichiei Narita
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-15
Journal Detail:
Title:  The Journal of rheumatology     Volume:  -     ISSN:  0315-162X     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From Niigata University Health Administration Center; Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture; Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences; Department of Internal Medicine, Nagaoka Red Cross Hospital; and Department of Medical Technology, School of Health Sciences, Faculty of Medicine, Niigata University, Niigata, Japan.
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