最新リウマチ情報
08/11 EULAR: Timely detection of axial spondyloarthritis
08/12 Horoscopes
07/21 High-dose glucocorticoids and IL-6 receptor inhibition reduce COVID-19-associated cytokine storm mortality
08/13 Combination of gout and diabetes carries increased risk of amputation
02/12 What is the Difference Between Arthritis and Rheumatism?
08/13 Psoriatic Arthritis Treatment Patterns and Costs Among Pharmacologic Treatment?Naïve Patients
08/14 Navidea Biopharmaceuticals Reports Second Quarter and Year-to-Date 2020 Financial Results
07/16 Researchers probe impediments to timely detection of axial spondyloarthritis
08/13 Extreme Weather Leaves Parts of South Sudan Submerged
08/08 Your COVID-19 symptoms could be valley fever. Here's what you need to know
07/22 Target Enrollment Reached in MIRROR Randomized Controlled Trial Evaluating KRYSTEXXA® (pegloticase injection) Co-Prescribed with Methotrexate as an Immunomodulator to Enhance Response Rates for People Living with Uncontrolled Gout
08/11 Woman in her 20s dies from COVID-19 in Palestine
04/23 Anti-rheumatism drug that also works on COVID-19
05/09 Berthoudites soothed their rheumatism at Excelsior Springs
06/17 EULAR: Early and intensive treatment of rheumatoid arthritis reduces fatigue
08/11 Kuwait MOH adopts new guidelines for medical consultations
05/06 Anti-rheumatism drug could help those with severe COVID-19 signs : The Asahi Shimbun
06/08 The European League Against Rheumatism, EULAR, launches Virtual Research Centre
04/16 Rheumatic disease and COVID-19: initial data from the COVID-19 Global Rheumatology Alliance provider registries
06/03 Navidea Biopharmaceuticals Announces Acceptance of Abstract for Presentation at the European League Against Rheumatism (EULAR) Congress
08/12 Newspapers ? A Window into the Past (Part 2)
07/07 Treatment with methotrexate and risk of lung disease in patients with rheumatoid arthritis
06/05 EULAR 2020: Thrombosis risk particularly high for people suffering
07/21 Alex's Trebek's Memoir: Love, Cancer, More Revelations From His Life
06/30 Moving the diagosis of rheumatic diseases into the era of precision medicine
06/04 Majority of Patients With Rheumatic Conditions Recover From COVID-19 Regardless of Rheumatic Disease Therapy
06/08 Alpine Immune Sciences Provides Clinical Update of its Phase 1 Trial of ALPN-101 in Healthy Volunteers at the European League Against Rheumatism (EULAR) E-Congress 2020
08/14 Edited Transcript of NAVB earnings conference call or presentation 13-Aug-20 9:00pm GMT
07/10 How COVID-19 lockdown has impacted people with arthritis
07/17 Inflammatory rheumatism: Types, symptoms, and treatments
06/30 Joint cell finding gives clues for improved treatment of rheumatoid arthritis
11/18 Rheumatism Center / Krampe Schmidt Architects BDA
08/11 Revisiting the industrial revolution in scientific lasers
06/17 Carotid Plaques Predict Cardiovascular Events and Mortality in Patients With Rheumatoid Arthritis
06/09 EULAR advocates deployment of health care professionals -- study confirms effectiveness
06/10 Rheumatoid arthritis drug shows promise against COVID-19, study finds
04/24 COVID-19-linked changes reported in rheumatic disease patient care
04/24 Controversy persists for palindromic rheumatism: RA precursor or distinct entity?
06/04 Filgotinib Demonstrates Durable Efficacy and Consistent Safety Profile at 52 Weeks in FINCH 1 and 3 Studies in Rheumatoid Arthritis
03/16 Expert Advice on Coronavirus Risk in Immunocompromised Patients With Rheumatic Diseases
06/09 Rheumatic disease in the context of COVID-19
04/29 How lockdown impacts those with bone, joint and muscle pain
07/07 Heart Disease Often Missed in Rheumatoid Arthritis
05/13 EULAR 2020
11/14 The Many Benefits of, and Barriers to, Exercise in Patients With Rheumatologic Diseases
01/20 Ultrasound could help reduce the use of drugs for patients with rheumatoid arthritis
10/24 AbbVie draws favorable rating for its rheumatism drug in Europe
03/17 A protein that controls inflammation
05/13 Rheumatology visit within 6 weeks of RA symptom onset increases chance for remission
09/12 Palindromic rheumatism: What it is, symptoms, and outlook
08/07 Recalling Underground Railroad
04/17 From the throat to the heart: Charting the long history of rheumatic fever
06/03 Study on COVID-19 and RMD provides reassurance to patients on immunosuppressive medication
09/08 China seeks therapy for rheumatism with traditional Chinese medicine
06/18 Patients with rheumatic disease, COVID-19 more likely to require ventilation
06/15 EULAR Provides COVID-19 Recommendations
07/13 Rheumatoid Arthritis Treatment Doesn't Harm Lungs: Study
11/10 Some people with RA treated with immune checkpoint inhibitors for cancer have flare, most able to continue treatment
06/05 Interferon Inhibition With Anifrolumab Reduces Disease Activity in Systemic Lupus Erythematosus
01/21 Proteins that protect against joint inflammation identified
06/09 Upadacitinib Looks Effective for Psoriatic Arthritis
06/05 New Analyses of Phase 2 EQUATOR Clinical Program Support Durable Efficacy of Filgotinib in Psoriatic Arthritis
02/10 Tocilizumab in isolated polymyalgia rheumatica: A systematic literature review
10/01 How a plant-based diet can ease rheumatoid arthritis
07/04 Left untreated, arthritis can affect organs, lower life expectancy
10/24 Smartphone study shows pain more likely on humid, windy days
09/11 2019 EULAR/ACR Recommendations for SLE Classification Criteria
05/15 Rituximab Effectively Treats ‘Forerunner’ of RA
01/29 One step closer to tailored treatment of severe rheumatic diseases
04/27 Updated EULAR/ERA-EDTA Recommendations for the Management of Lupus Nephritis
06/18 Snuffing Out Inflammation
03/30 How Clinicians Can Manage Rheumatic and Immune Diseases During COVID-19
10/08 Experimental growth factor shows promise for treating knee osteoarthritis
06/06 New option for treating active rheumatoid arthritis
04/03 Palm trees can help cure headaches, rheumatism
10/11 The Daily Biotech Pulse: Therapix Extends Merger Deadline, Five Prime Restructures, Gilead-Galapagos Rheumatism Drug Readout
10/22 What is a rheumatologist? Medical conditions, procedures, and more
04/23 Anti-inflammatory drugs protect against Covid-19
06/01 Psoriatic arthritis
01/13 2019 ACR/EULAR Classification Criteria for IgG4-Related Disease
03/03 Cancer drugs shed light on rheumatism
03/07 Rheumatology Conference: South Carolina Rheumatism Society 2019 Annual Meeting
04/01 The Prescription for Rheumatism Used to Be to Sit Inside a Rotting Whale for 30 Hours
06/14 Suicidal thoughts related to pain in 1 in 10 patients with rheumatic or musculoskeletal disease
04/28 Coronavirus: over 50 patients helped with anti-rheumatic drug
06/22 Coronavirus cases worldwide pass 9 million
12/05 Rheumatism treatment effective even when the use of biological agents is slightly delayed
11/14 How to forge rhinoceros horn
10/12 World Arthritis Day 2019: History and Theme
06/12 Exposure to inorganic dust increases risk of gout in women by 27%
06/12 Real-World Data on SB4 Highlight Biosimilar Etanercept's Efficacy
06/18 Nerve Stimulator Showing Promise in Rheumatoid Arthritis
06/15 Gum disease may be a key initiator of rheumatoid arthritis related autoimmunity: Significantly higher prevalence of gum disease found in individuals at risk of rheumatoid arthritis compared to healthy controls
03/30 Rheumatism sufferers sought relief inside a whale
09/10 US billionaire Bloomberg pledges $160m to fight vaping
09/12 Updated 2019 EULAR Recommendations for Vaccination in Adults With Autoimmune Inflammatory Rheumatic Diseases
04/20 Rheumatoid Arthritis and Working on the Job
09/24 Study shows the biological clock influences immune response efficiency
06/17 FDA warns MediNatura against 'potentially toxic' homeopathic injectables for joint disease
06/19 Infection Rates Rise in RA After Joint Surgery
08/12 Horoscopes
07/21 High-dose glucocorticoids and IL-6 receptor inhibition reduce COVID-19-associated cytokine storm mortality
08/13 Combination of gout and diabetes carries increased risk of amputation
02/12 What is the Difference Between Arthritis and Rheumatism?
08/13 Psoriatic Arthritis Treatment Patterns and Costs Among Pharmacologic Treatment?Naïve Patients
08/14 Navidea Biopharmaceuticals Reports Second Quarter and Year-to-Date 2020 Financial Results
07/16 Researchers probe impediments to timely detection of axial spondyloarthritis
08/13 Extreme Weather Leaves Parts of South Sudan Submerged
08/08 Your COVID-19 symptoms could be valley fever. Here's what you need to know
07/22 Target Enrollment Reached in MIRROR Randomized Controlled Trial Evaluating KRYSTEXXA® (pegloticase injection) Co-Prescribed with Methotrexate as an Immunomodulator to Enhance Response Rates for People Living with Uncontrolled Gout
08/11 Woman in her 20s dies from COVID-19 in Palestine
04/23 Anti-rheumatism drug that also works on COVID-19
05/09 Berthoudites soothed their rheumatism at Excelsior Springs
06/17 EULAR: Early and intensive treatment of rheumatoid arthritis reduces fatigue
08/11 Kuwait MOH adopts new guidelines for medical consultations
05/06 Anti-rheumatism drug could help those with severe COVID-19 signs : The Asahi Shimbun
06/08 The European League Against Rheumatism, EULAR, launches Virtual Research Centre
04/16 Rheumatic disease and COVID-19: initial data from the COVID-19 Global Rheumatology Alliance provider registries
06/03 Navidea Biopharmaceuticals Announces Acceptance of Abstract for Presentation at the European League Against Rheumatism (EULAR) Congress
08/12 Newspapers ? A Window into the Past (Part 2)
07/07 Treatment with methotrexate and risk of lung disease in patients with rheumatoid arthritis
06/05 EULAR 2020: Thrombosis risk particularly high for people suffering
07/21 Alex's Trebek's Memoir: Love, Cancer, More Revelations From His Life
06/30 Moving the diagosis of rheumatic diseases into the era of precision medicine
06/04 Majority of Patients With Rheumatic Conditions Recover From COVID-19 Regardless of Rheumatic Disease Therapy
06/08 Alpine Immune Sciences Provides Clinical Update of its Phase 1 Trial of ALPN-101 in Healthy Volunteers at the European League Against Rheumatism (EULAR) E-Congress 2020
08/14 Edited Transcript of NAVB earnings conference call or presentation 13-Aug-20 9:00pm GMT
07/10 How COVID-19 lockdown has impacted people with arthritis
07/17 Inflammatory rheumatism: Types, symptoms, and treatments
06/30 Joint cell finding gives clues for improved treatment of rheumatoid arthritis
11/18 Rheumatism Center / Krampe Schmidt Architects BDA
08/11 Revisiting the industrial revolution in scientific lasers
06/17 Carotid Plaques Predict Cardiovascular Events and Mortality in Patients With Rheumatoid Arthritis
06/09 EULAR advocates deployment of health care professionals -- study confirms effectiveness
06/10 Rheumatoid arthritis drug shows promise against COVID-19, study finds
04/24 COVID-19-linked changes reported in rheumatic disease patient care
04/24 Controversy persists for palindromic rheumatism: RA precursor or distinct entity?
06/04 Filgotinib Demonstrates Durable Efficacy and Consistent Safety Profile at 52 Weeks in FINCH 1 and 3 Studies in Rheumatoid Arthritis
03/16 Expert Advice on Coronavirus Risk in Immunocompromised Patients With Rheumatic Diseases
06/09 Rheumatic disease in the context of COVID-19
04/29 How lockdown impacts those with bone, joint and muscle pain
07/07 Heart Disease Often Missed in Rheumatoid Arthritis
05/13 EULAR 2020
11/14 The Many Benefits of, and Barriers to, Exercise in Patients With Rheumatologic Diseases
01/20 Ultrasound could help reduce the use of drugs for patients with rheumatoid arthritis
10/24 AbbVie draws favorable rating for its rheumatism drug in Europe
03/17 A protein that controls inflammation
05/13 Rheumatology visit within 6 weeks of RA symptom onset increases chance for remission
09/12 Palindromic rheumatism: What it is, symptoms, and outlook
08/07 Recalling Underground Railroad
04/17 From the throat to the heart: Charting the long history of rheumatic fever
06/03 Study on COVID-19 and RMD provides reassurance to patients on immunosuppressive medication
09/08 China seeks therapy for rheumatism with traditional Chinese medicine
06/18 Patients with rheumatic disease, COVID-19 more likely to require ventilation
06/15 EULAR Provides COVID-19 Recommendations
07/13 Rheumatoid Arthritis Treatment Doesn't Harm Lungs: Study
11/10 Some people with RA treated with immune checkpoint inhibitors for cancer have flare, most able to continue treatment
06/05 Interferon Inhibition With Anifrolumab Reduces Disease Activity in Systemic Lupus Erythematosus
01/21 Proteins that protect against joint inflammation identified
06/09 Upadacitinib Looks Effective for Psoriatic Arthritis
06/05 New Analyses of Phase 2 EQUATOR Clinical Program Support Durable Efficacy of Filgotinib in Psoriatic Arthritis
02/10 Tocilizumab in isolated polymyalgia rheumatica: A systematic literature review
10/01 How a plant-based diet can ease rheumatoid arthritis
07/04 Left untreated, arthritis can affect organs, lower life expectancy
10/24 Smartphone study shows pain more likely on humid, windy days
09/11 2019 EULAR/ACR Recommendations for SLE Classification Criteria
05/15 Rituximab Effectively Treats ‘Forerunner’ of RA
01/29 One step closer to tailored treatment of severe rheumatic diseases
04/27 Updated EULAR/ERA-EDTA Recommendations for the Management of Lupus Nephritis
06/18 Snuffing Out Inflammation
03/30 How Clinicians Can Manage Rheumatic and Immune Diseases During COVID-19
10/08 Experimental growth factor shows promise for treating knee osteoarthritis
06/06 New option for treating active rheumatoid arthritis
04/03 Palm trees can help cure headaches, rheumatism
10/11 The Daily Biotech Pulse: Therapix Extends Merger Deadline, Five Prime Restructures, Gilead-Galapagos Rheumatism Drug Readout
10/22 What is a rheumatologist? Medical conditions, procedures, and more
04/23 Anti-inflammatory drugs protect against Covid-19
06/01 Psoriatic arthritis
01/13 2019 ACR/EULAR Classification Criteria for IgG4-Related Disease
03/03 Cancer drugs shed light on rheumatism
03/07 Rheumatology Conference: South Carolina Rheumatism Society 2019 Annual Meeting
04/01 The Prescription for Rheumatism Used to Be to Sit Inside a Rotting Whale for 30 Hours
06/14 Suicidal thoughts related to pain in 1 in 10 patients with rheumatic or musculoskeletal disease
04/28 Coronavirus: over 50 patients helped with anti-rheumatic drug
06/22 Coronavirus cases worldwide pass 9 million
12/05 Rheumatism treatment effective even when the use of biological agents is slightly delayed
11/14 How to forge rhinoceros horn
10/12 World Arthritis Day 2019: History and Theme
06/12 Exposure to inorganic dust increases risk of gout in women by 27%
06/12 Real-World Data on SB4 Highlight Biosimilar Etanercept's Efficacy
06/18 Nerve Stimulator Showing Promise in Rheumatoid Arthritis
06/15 Gum disease may be a key initiator of rheumatoid arthritis related autoimmunity: Significantly higher prevalence of gum disease found in individuals at risk of rheumatoid arthritis compared to healthy controls
03/30 Rheumatism sufferers sought relief inside a whale
09/10 US billionaire Bloomberg pledges $160m to fight vaping
09/12 Updated 2019 EULAR Recommendations for Vaccination in Adults With Autoimmune Inflammatory Rheumatic Diseases
04/20 Rheumatoid Arthritis and Working on the Job
09/24 Study shows the biological clock influences immune response efficiency
06/17 FDA warns MediNatura against 'potentially toxic' homeopathic injectables for joint disease
06/19 Infection Rates Rise in RA After Joint Surgery
リウマチとは
リウマチとは
- 「リウマチ」、「リューマチ」、「リュウマチ」、「ロイマチ」とよばれます。
- 英語では、"Rheumatism", "Rheuma" と表記します。
- からだのあちこちの関節に炎症が起こり、関節が腫れて痛む病気です。
- 進行すると関節の変形や機能障害（使えなくなること）が起こります。
- おもに、下の２つが代表的な疾患とされます。
- 関節リウマチ と、
- リウマチ熱
日本全国でリウマチに悩む人は１００万人ともいわれ、その数は社会の高齢化にともない、年々増加しています。
リウマチ専門医・病院・クリニック検索
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病院
関節リウマチ ( Rheumatoid Arthritis, RA )
関節リウマチ ( Rheumatoid Arthritis, RA )
関節リウマチ(Rheumatoid Arthritis：RA）は、自己の免疫が主に手足の関節を侵し、これにより関節痛、関節の変形が生じる代表的な膠原病の一つで、炎症性自己免疫疾患です。しばしば血管、心臓、肺、皮膚、筋肉といった全身臓器にも障害が及びます。
関節リウマチの原因
関節リウマチの原因
- 完全には病気の原因は究明されていません。
- 自己の免疫系（細菌などから体を防御するシステム）に異常があることが知られています。
- 免疫細胞が攻撃を始める根本原因は不明です。
- 遺伝的なもの（遺伝子が関係する）
- 感染した微生物（ウイルスや細菌）の影響
- 妊娠や出産など女性ホルモンの変化
関節リウマチの診断・早期診断(関節リウマチが疑われる症状)
リウマチの診断
多くの病院では、1987年米国リウマチ学会によって提唱された分類基準を参考にして、関節リウマチかどうかの診断します。（1994年に日本リウマチ学会が提唱した「早期関節リウマチの診断基準」を使う病院もあります。）
- 朝のこわばりが、少なくとも1時間以上にわたってみられる
- 3つ以上の関節に炎症による腫れがみられる
- 手首や手指のつけ根の関節、手指の第2関節に炎症による腫れがみられる
- 左右対称の関節に炎症による腫れがみられる
- 皮下結節（リウマトイド結節）がひじやひざなどにみられる
- 血液検査でリウマトイド因子が陽性である
- X線検査で手の関節に骨の萎縮などの変化がみられる
上記の7項目のうち、4項目以上にあてはまる場合を関節リウマチとする、とされています。
早期診断・リウマチが疑われる症状
早期のリウマチ患者では上記の基準に当てはまらないことも多くあります。以下は、リウマチを疑ったほうがよいとされる症状です。
- 関節の痛み、腫れがある
- 特に朝に、関節がこわばる
- 多くの関節に症状がある（3か所〜程度）
- 左右対称に症状がある（例：右手指と左手指）
関節リウマチの症状
関節リウマチの症状
- 関節炎
- 初期の症状「朝のこわばり(morning stiffness)」
朝起きてから、手をにぎることが困難であり、文字通りこわばります。
5-10分程度のこわばりは他の疾患でも診られますが、1時間以上も続くこわばりであれば関節リウマチまたは他のリウマチ性疾患の可能性が高い様です。
- そのうち、関節痛がおこるようになり、手指や足指の関節がおかされ、次第に手首、肘、膝など体の中心に近い大きな関節の痛みを感じるようになります。
- 関節痛は、手を動かすなど活動すると増強します。
- 関節炎が進行すると、関節そのものが変性し、最終的には関節が破壊し尽くされ、骨と骨が直接接した強直という状態になります。
- 手足の関節の他では、胸・腰の背骨はおかされないが首の背骨（頚椎）はおかされやすいようです。
- 頚部痛を生じたり、脊髄損傷、また、鎖骨に関節痛が起こる事もあります。
- 初期の症状「朝のこわばり(morning stiffness)」
- 血管
血管病変を合併する場合には、全身にくまなく留意しなければなりません。
心臓では狭心症・心筋梗塞、肺では肺高血圧症、腎臓では糸球体硬化症、脳では脳梗塞が起こりえます。
- 眼
関節リウマチ患者には、ドライアイもよく見られ、目の内側にリウマトイド結節が生じることもあります。
- 呼吸器
間質性肺炎、気道病変、胸膜病変、リウマチ結節、血管病変、睡眠時無呼吸症候群（顎関節病変、輪状披裂関節病変）などを合併することがあります。
- 心臓
心膜炎やリウマトイド結節を生じることもあります。
- 神経
関節リウマチに伴い血管炎が生ずれば、それに伴い多発単神経炎が起こる事があります。
- 皮膚
圧のかかる部位に、リウマチ結節と呼ばれる病変や、皮下出血などもみられることがあります。
- 血液
重症の関節リウマチ患者においては、脾腫、白血球（好中球のみ）減少をきたします。
関節リウマチの治療
関節リウマチの治療
現在の治療指針では関節リウマチの診断がついたら、出来るだけ早期に抗リウマチ薬(DMARDs), 生物学的製剤を用いることが推奨されています。痛みに対する対症療法として非ステロイド系消炎鎮痛剤（NSAIDs）などを用います。
- DMARDs（抗リウマチ薬）
関節リウマチの病気の勢いそのものを弱める薬として、メトトレキサート（リウマトレックス®）、スルファサラジン（アザルフィジン®）、 ブシラミン（リマチル®）、レフルノミド（アラバ®）、ミゾリビン、タクロリムス（プログラフ®）が使用されます。
欧米では抗マラリア薬であるヒドロキシクロロキンも使用され、免疫抑制薬であるアザチオプリン（イムラン®）、シクロスポリン（ネオーラル®）も効果が示されています。
- ステロイド
臨床試験の結果、ステロイドもDMARDsと同様に、病気の進行を遅らせる効果を示すことがわかり、DMARDsのみよりもDMARDsにステロイドを加えたほうが 病気の進行をさらに遅らせるという研究結果も報告されています。
- 抗サイトカイン療法
インフリキシマブ（レミケード®）、アダリムマブ(ヒュミラ®)、トシリズマブ(アクテムラ®)、エタネルセプト（エンブレル®）、アバタセプト(オレンシア®)は新しく開発されています。
これらはリウマチに対してきわめて強力な治療効果を示していますが、これらの薬剤は免疫応答に対する抑制効果が強く、しばしば感染症を引き起こすことがあり、 抗菌薬の併用などによる十分な予防を行う必要があります。
- その他の研究段階の新しい治療法
悪性リンパ腫に効果のあるリツキシマブ（リツキサン®）、抗生剤であるテトラサイクリン、高脂血症治療薬であるスタチン、多発性骨髄腫治療薬であるサリドマイドの効果や、 造血幹細胞移植の効果も検討されています。
- ビオチン治療法
各ビタミンの相互作用により、血中ビオチン値の上昇を目的とし、脾臓細胞における、免疫不全症の改善治癒を行うための治療方法です。
今までは、免疫不全症の原因が不明であることから、対処療法薬の投与をおこなう寛解維持療法がおこなわれていましたが、昨今の研究で、免疫不全症の一部の原因が初めて特定され、 これにより、ビオチン治療が確立しました。