最新リウマチ情報
03/27 Rheumatic Arthritis or Rheumatism: How to keep the disease from progressing; tips to keep your mobility intact
04/15 2019 EULAR/ACR Criteria More Sensitive, Similarly Specific to 1997 ACR Criteria for Classification of Youth With SLE
04/15 UMCG research: junk food, sugar and drink cause intestinal inflammation and thus diabetes and rheumatism (vegetarian food has the opposite effect)
04/14 Botanical Roots: Why you should consume dandelion
04/10 Neem Leaves A Day Keeps Diseases At Bay
03/11 Roche rheumatism drug does not reduce Covid-19 deaths
02/12 What is the Difference Between Arthritis and Rheumatism?
11/05 Rheumatism drug could boost effectiveness of antibiotics against superbugs: study
04/12 [Full text] Association of Rheumatoid Arthritis with Diabetic Comorbidity: Correla | JMDH
07/17 Inflammatory rheumatism: Types, symptoms, and treatments
05/06 Anti-rheumatism drug could help those with severe COVID-19 signs : The Asahi Shimbun
04/24 Controversy persists for palindromic rheumatism: RA precursor or distinct entity?
09/21 Long-term hydroxychloroquine use in patients with rheumatic conditions and development of SARS-CoV-2 infection: a retrospective cohort study
04/06 Bonneville selected as next superintendent of Hampshire Regional School District
02/10 Mass Rheumatism Medicine Distribution Program To Start In Bhubaneswar From Today
11/23 First flare of ACPA-positive rheumatoid arthritis after SARS-CoV-2 infection
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
09/12 Palindromic rheumatism: What it is, symptoms, and outlook
10/29 Hydroxychloroquine in patients with rheumatic diseases during the COVID-19 pandemic: a letter to clinicians
06/05 EULAR 2020: Thrombosis risk particularly high for people suffering
06/15 EULAR Provides COVID-19 Recommendations
04/12 Folk remedies important in early life of Surry County
08/19 Osteoarthritis: Conservative therapy delays need for knee and hip joint replacement surgery
04/15 No potli please, Camphor, Lavang do not elevate oxygen level
03/03 Cancer drugs shed light on rheumatism
07/24 Rheumatoid arthritis drug may fight severe COVID-19, early data show
11/18 Rheumatism Center / Krampe Schmidt Architects BDA
07/07 Treatment with methotrexate and risk of lung disease in patients with rheumatoid arthritis
06/04 Most Rheumatology Drugs Don't Up COVID-19 Hospitalization
06/03 New First-in-Class Phase 3 TREMFYA® (guselkumab) Data Demonstrate Improvement in Psoriatic Arthritis Joint and Skin Symptoms at Week 52
06/18 Patients with rheumatic disease, COVID-19 more likely to require ventilation
09/08 China seeks therapy for rheumatism with traditional Chinese medicine
04/16 Rheumatic disease and COVID-19: initial data from the COVID-19 Global Rheumatology Alliance provider registries
06/05 Interferon Inhibition With Anifrolumab Reduces Disease Activity in Systemic Lupus Erythematosus
03/16 Expert Advice on Coronavirus Risk in Immunocompromised Patients With Rheumatic Diseases
06/17 EULAR 2020: highlights from the European e-Congress of Rheumatology
12/01 The Pros and Cons of Coffee for Arthritis
10/22 For Some Patients with Rheumatoid Arthritis, Oral Analgesics May Not Improve Quality of Life
01/05 Mum given three days to live after catching Covid-19 recovers with 'last resort' experimental drug
04/01 The Prescription for Rheumatism Used to Be to Sit Inside a Rotting Whale for 30 Hours
06/08 Abbvie's Rinvoq matches BMS' Orencia in head-to-head rheumatoid arthritis trial
02/24 Increased apolipoprotein-B:A1 ratio predicts cardiometabolic risk in patients with juvenile onset SLE
07/23 In Alex Trebek’s reluctant, moving memoir, life is all about the next question
06/12 Real-World Results and Long-Term Safety Data for Secukinumab
07/30 8 hand exercises for arthritis: Pictures and the necessary equipment
05/15 Rituximab Effectively Treats ‘Forerunner’ of RA
10/24 AbbVie draws favorable rating for its rheumatism drug in Europe
12/02 Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised, observer blinded clinical trial
04/20 Rheumatoid Arthritis and Working on the Job
04/17 From the throat to the heart: Charting the long history of rheumatic fever
06/03 ArthritisPower® Data Shows that Patient Engagement with Digital Tools Enhances Understanding of Arthritis ? Welcomed News Amidst Worldwide Pandemic Forcing Digital Engagement
06/05 Magenta Therapeutics Presents Data Supporting Immune Reset for Autoimmune Diseases
04/03 Palm trees can help cure headaches, rheumatism
04/29 What Rheumatologists Need to Know About Vaccines in Rheumatic Diseases
07/07 RELATED: "Heart Disease Often Missed in Rheumatoid Arthritis"
06/17 Early and intensive treatment of rheumatoid arthritis reduces fatigue
08/26 Rheumatoid Arthritis Diagnosis & Tests: How Doctors Diagnose RA
09/11 2019 EULAR/ACR Recommendations for SLE Classification Criteria
03/30 Rheumatism sufferers sought relief inside a whale
12/19 Arthritis, rheumatism and total joint arthroplasty: an interview with Dr Ravi and Dr Hawker
06/12 Real-World Data on SB4 Highlight Biosimilar Etanercept's Efficacy
03/31 EULAR launches COVID-19 RMD reporting database as part of Global Rheumatology Alliance
07/02 Can Copper or Magnetic Bracelets Ease Your Arthritis?
10/30 'I Was Diagnosed With Rheumatoid Arthritis at 40?Right After I Had a Baby'
09/04 What is autoimmune arthritis? Symptoms and treatment
09/05 Pfizer Korea releases new tool for rheumatism injection
06/14 Inflammatory bowel disease and type I diabetes increase chances of developing rheumatoid arthritis
10/16 Are There Benefits to Drinking Kombucha?
01/29 One step closer to tailored treatment of severe rheumatic diseases
11/19 Start Treatment Early in RA, Even in Seronegatives
11/07 Why an English Museum Has a Collection of Magic Potatoes
06/09 5 Common Types of Arthritis
06/12 Efficacy of Filgotinib in Methotrexate-Naive Patients With Rheumatoid Arthritis
06/03 Celltrion Healthcare showcases positive 1-year data and budget impact analysis for novel subcutaneous formulation of infliximab in patients with rheumatoid arthritis at the European E-Congress of Rheumatology 2020
09/28 Eating cherries lowers risk of gout attacks by 35 percent
03/30 How Clinicians Can Manage Rheumatic and Immune Diseases During COVID-19
07/07 Comparative effectiveness of biological medicines in rheumatoid arthritis: systematic review and network meta-analysis including aggregate results from reanalysed individual patient data
06/09 Article Upadacitinib Looks Effective for Psoriatic Arthritis
03/31 Australians bathed inside rotting whales to 'cure' rheumatism
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
04/02 Management of Sjögren's syndrome with topical and systemic therapies
02/26 Gout: Two New Studies Show Benefits of DECT and Ultrasound for Diagnosis and Monitoring
06/12 All men with gout should be routinely screened for erectile dysfunction
04/02 New SLE Classification Criteria
06/03 Expanding Arthritis Therapies Top Agenda at EULAR
08/28 Broccoli Could Help Fight Arthritis ? WebMD
09/17 Rheumatoid arthritis and pregnancy: Advice, effects, and planning
10/22 What is a rheumatologist? Medical conditions, procedures, and more
04/25 European League Against Rheumatism (EULAR) 2005 Annual Meeting
07/25 Did you know orchids can cure rheumatism?
10/01 How a plant-based diet can ease rheumatoid arthritis
03/01 Will we need COVID-19 booster shots? Study considers more vaccinations
06/12 Secukinumab Improves Axial Manifestations in Psoriatic Arthritis
06/11 Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days
06/17 Triple Therapy as Good as Biologics for Rheumatoid Arthritis
01/08 Kambo: What to Know About Frog Medicine
12/17 Top 12 Rheumatology Books of 2019
01/01 Rheuminations: Blame the Pain on the Rain?
09/12 Rheumatoid arthritis and insomnia: Tips for better sleep
06/13 EULAR Recommendations for Management of Henoch-Schönlein Purpura
04/15 2019 EULAR/ACR Criteria More Sensitive, Similarly Specific to 1997 ACR Criteria for Classification of Youth With SLE
04/15 UMCG research: junk food, sugar and drink cause intestinal inflammation and thus diabetes and rheumatism (vegetarian food has the opposite effect)
04/14 Botanical Roots: Why you should consume dandelion
04/10 Neem Leaves A Day Keeps Diseases At Bay
03/11 Roche rheumatism drug does not reduce Covid-19 deaths
02/12 What is the Difference Between Arthritis and Rheumatism?
11/05 Rheumatism drug could boost effectiveness of antibiotics against superbugs: study
04/12 [Full text] Association of Rheumatoid Arthritis with Diabetic Comorbidity: Correla | JMDH
07/17 Inflammatory rheumatism: Types, symptoms, and treatments
05/06 Anti-rheumatism drug could help those with severe COVID-19 signs : The Asahi Shimbun
04/24 Controversy persists for palindromic rheumatism: RA precursor or distinct entity?
09/21 Long-term hydroxychloroquine use in patients with rheumatic conditions and development of SARS-CoV-2 infection: a retrospective cohort study
04/06 Bonneville selected as next superintendent of Hampshire Regional School District
02/10 Mass Rheumatism Medicine Distribution Program To Start In Bhubaneswar From Today
11/23 First flare of ACPA-positive rheumatoid arthritis after SARS-CoV-2 infection
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
09/12 Palindromic rheumatism: What it is, symptoms, and outlook
10/29 Hydroxychloroquine in patients with rheumatic diseases during the COVID-19 pandemic: a letter to clinicians
06/05 EULAR 2020: Thrombosis risk particularly high for people suffering
06/15 EULAR Provides COVID-19 Recommendations
04/12 Folk remedies important in early life of Surry County
08/19 Osteoarthritis: Conservative therapy delays need for knee and hip joint replacement surgery
04/15 No potli please, Camphor, Lavang do not elevate oxygen level
03/03 Cancer drugs shed light on rheumatism
07/24 Rheumatoid arthritis drug may fight severe COVID-19, early data show
11/18 Rheumatism Center / Krampe Schmidt Architects BDA
07/07 Treatment with methotrexate and risk of lung disease in patients with rheumatoid arthritis
06/04 Most Rheumatology Drugs Don't Up COVID-19 Hospitalization
06/03 New First-in-Class Phase 3 TREMFYA® (guselkumab) Data Demonstrate Improvement in Psoriatic Arthritis Joint and Skin Symptoms at Week 52
06/18 Patients with rheumatic disease, COVID-19 more likely to require ventilation
09/08 China seeks therapy for rheumatism with traditional Chinese medicine
04/16 Rheumatic disease and COVID-19: initial data from the COVID-19 Global Rheumatology Alliance provider registries
06/05 Interferon Inhibition With Anifrolumab Reduces Disease Activity in Systemic Lupus Erythematosus
03/16 Expert Advice on Coronavirus Risk in Immunocompromised Patients With Rheumatic Diseases
06/17 EULAR 2020: highlights from the European e-Congress of Rheumatology
12/01 The Pros and Cons of Coffee for Arthritis
10/22 For Some Patients with Rheumatoid Arthritis, Oral Analgesics May Not Improve Quality of Life
01/05 Mum given three days to live after catching Covid-19 recovers with 'last resort' experimental drug
04/01 The Prescription for Rheumatism Used to Be to Sit Inside a Rotting Whale for 30 Hours
06/08 Abbvie's Rinvoq matches BMS' Orencia in head-to-head rheumatoid arthritis trial
02/24 Increased apolipoprotein-B:A1 ratio predicts cardiometabolic risk in patients with juvenile onset SLE
07/23 In Alex Trebek’s reluctant, moving memoir, life is all about the next question
06/12 Real-World Results and Long-Term Safety Data for Secukinumab
07/30 8 hand exercises for arthritis: Pictures and the necessary equipment
05/15 Rituximab Effectively Treats ‘Forerunner’ of RA
10/24 AbbVie draws favorable rating for its rheumatism drug in Europe
12/02 Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised, observer blinded clinical trial
04/20 Rheumatoid Arthritis and Working on the Job
04/17 From the throat to the heart: Charting the long history of rheumatic fever
06/03 ArthritisPower® Data Shows that Patient Engagement with Digital Tools Enhances Understanding of Arthritis ? Welcomed News Amidst Worldwide Pandemic Forcing Digital Engagement
06/05 Magenta Therapeutics Presents Data Supporting Immune Reset for Autoimmune Diseases
04/03 Palm trees can help cure headaches, rheumatism
04/29 What Rheumatologists Need to Know About Vaccines in Rheumatic Diseases
07/07 RELATED: "Heart Disease Often Missed in Rheumatoid Arthritis"
06/17 Early and intensive treatment of rheumatoid arthritis reduces fatigue
08/26 Rheumatoid Arthritis Diagnosis & Tests: How Doctors Diagnose RA
09/11 2019 EULAR/ACR Recommendations for SLE Classification Criteria
03/30 Rheumatism sufferers sought relief inside a whale
12/19 Arthritis, rheumatism and total joint arthroplasty: an interview with Dr Ravi and Dr Hawker
06/12 Real-World Data on SB4 Highlight Biosimilar Etanercept's Efficacy
03/31 EULAR launches COVID-19 RMD reporting database as part of Global Rheumatology Alliance
07/02 Can Copper or Magnetic Bracelets Ease Your Arthritis?
10/30 'I Was Diagnosed With Rheumatoid Arthritis at 40?Right After I Had a Baby'
09/04 What is autoimmune arthritis? Symptoms and treatment
09/05 Pfizer Korea releases new tool for rheumatism injection
06/14 Inflammatory bowel disease and type I diabetes increase chances of developing rheumatoid arthritis
10/16 Are There Benefits to Drinking Kombucha?
01/29 One step closer to tailored treatment of severe rheumatic diseases
11/19 Start Treatment Early in RA, Even in Seronegatives
11/07 Why an English Museum Has a Collection of Magic Potatoes
06/09 5 Common Types of Arthritis
06/12 Efficacy of Filgotinib in Methotrexate-Naive Patients With Rheumatoid Arthritis
06/03 Celltrion Healthcare showcases positive 1-year data and budget impact analysis for novel subcutaneous formulation of infliximab in patients with rheumatoid arthritis at the European E-Congress of Rheumatology 2020
09/28 Eating cherries lowers risk of gout attacks by 35 percent
03/30 How Clinicians Can Manage Rheumatic and Immune Diseases During COVID-19
07/07 Comparative effectiveness of biological medicines in rheumatoid arthritis: systematic review and network meta-analysis including aggregate results from reanalysed individual patient data
06/09 Article Upadacitinib Looks Effective for Psoriatic Arthritis
03/31 Australians bathed inside rotting whales to 'cure' rheumatism
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
04/02 Management of Sjögren's syndrome with topical and systemic therapies
02/26 Gout: Two New Studies Show Benefits of DECT and Ultrasound for Diagnosis and Monitoring
06/12 All men with gout should be routinely screened for erectile dysfunction
04/02 New SLE Classification Criteria
06/03 Expanding Arthritis Therapies Top Agenda at EULAR
08/28 Broccoli Could Help Fight Arthritis ? WebMD
09/17 Rheumatoid arthritis and pregnancy: Advice, effects, and planning
10/22 What is a rheumatologist? Medical conditions, procedures, and more
04/25 European League Against Rheumatism (EULAR) 2005 Annual Meeting
07/25 Did you know orchids can cure rheumatism?
10/01 How a plant-based diet can ease rheumatoid arthritis
03/01 Will we need COVID-19 booster shots? Study considers more vaccinations
06/12 Secukinumab Improves Axial Manifestations in Psoriatic Arthritis
06/11 Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days
06/17 Triple Therapy as Good as Biologics for Rheumatoid Arthritis
01/08 Kambo: What to Know About Frog Medicine
12/17 Top 12 Rheumatology Books of 2019
01/01 Rheuminations: Blame the Pain on the Rain?
09/12 Rheumatoid arthritis and insomnia: Tips for better sleep
06/13 EULAR Recommendations for Management of Henoch-Schönlein Purpura
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。
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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。