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Rheumatology International

, Volume 33, Issue 4, pp 871–877 | Cite as

Long-term therapeutic effects and safety of tacrolimus added to methotrexate in patients with rheumatoid arthritis

  • Takeyuki Kanzaki
  • Kimito Kawahata
  • Hiroko Kanda
  • Keishi Fujio
  • Kanae Kubo
  • Lisa Akahira
  • Kazuya Michishita
  • Toshiki Eri
  • Kazuhiko Yamamoto
Original Article

Abstract

To assess the long-term safety and efficacy of tacrolimus (TAC) used in combination with oral methotrexate (MTX) in patients with rheumatoid arthritis (RA) whose disease remains active despite treatment with MTX alone. The clinical courses of 24 RA patients who received TAC added to MTX from a single center were analyzed retrospectively. The disease activity was evaluated by the DAS28-ESR(3) every 12 months after the addition of TAC, and side effects were evaluated for 3 years. At 3 years after starting the treatment, TAC was still being used by 19 patients (79 %). The causes of discontinuation were an inadequate response (3 cases), oral ulcers and elevation of creatinine (1 case), and worsening of interstitial pneumonia (1 case). No death was registered. The DAS28-ESR(3) was decreased from 4.81 to 3.41 after 3 years of treatment. The doses of prednisolone were decreased from 5.1 mg/day to 3.2 mg/day after 3 years. In patients whose active RA persists despite treatment with MTX, TAC in combination with MTX is safe and well tolerated and provided clinical benefit for a long time in this single-center retrospective study. Further studies are required to confirm the safety and efficacy of this combination therapy.

Keywords

Combination therapy Methotrexate Rheumatoid arthritis Tacrolimus 

Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Takeyuki Kanzaki
    • 1
  • Kimito Kawahata
    • 1
  • Hiroko Kanda
    • 1
  • Keishi Fujio
    • 1
  • Kanae Kubo
    • 1
  • Lisa Akahira
    • 1
  • Kazuya Michishita
    • 1
  • Toshiki Eri
    • 1
  • Kazuhiko Yamamoto
    • 1
  1. 1.Department of Allergy and Rheumatology, Graduate School of MedicineThe University of TokyoTokyoJapan

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