Rheumatology International

, Volume 29, Issue 11, pp 1287–1291

Adding low dose tacrolimus in rheumatoid arthritis patients with an inadequate response to tumor necrosis factor inhibitor therapies

  • Taio Naniwa
  • Maiko Watanabe
  • Shogo Banno
  • Tomoyo Maeda
Original Paper

DOI: 10.1007/s00296-009-0845-3

Cite this article as:
Naniwa, T., Watanabe, M., Banno, S. et al. Rheumatol Int (2009) 29: 1287. doi:10.1007/s00296-009-0845-3

Abstract

In the present study, we retrospectively evaluate the efficacy of low dose tacrolimus (TAC) as add-on therapy in refractory rheumatoid arthritis (RA) despite a combination of tumor necrosis factor (TNF) inhibitor and methotrexate (MTX) using consecutive case series of five patients with active RA (mean disease duration 2.3 years) despite MTX and TNF inhibitors for at least 3 months (mean 9.5 months) treated with low dose TAC (1.5–2 mg/day) for at least 6 months (mean 1.8 years). Clinical and radiographic efficacy was assessed according to the European league against rheumatism response criteria and the modified Sharp method, respectively. At 1 year, three patients reached to remission. The mean yearly progression of radiographic joint damage of all five patients after the onset of TAC was significantly decreased compared to that observed during anti-TNF therapy without TAC (p = 0.04). One patient temporally discontinued the treatment because of herpes zoster. In RA patients with inadequate response to MTX and a TNF inhibitor, additions of low dose TAC markedly improved clinical variables including radiographic scores without remarkable detrimental effects. It seems that TAC in combination with MTX and TNF inhibitors may be a hopeful treatment option for RA patients with inadequate response to anti-TNF therapy.

Keywords

Rheumatoid arthritis Tacrolimus Infliximab Etanercept Combination drug therapy 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Taio Naniwa
    • 1
    • 2
  • Maiko Watanabe
    • 1
    • 2
  • Shogo Banno
    • 1
    • 2
  • Tomoyo Maeda
    • 1
    • 2
  1. 1.Division of RheumatologyNagoya City University HospitalNagoyaJapan
  2. 2.Department of Medical Oncology and ImmunologyNagoya City University Graduate School of Medical SciencesNagoyaJapan

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