Infliximab Therapy may Improve Depression in Patients with Rheumatoid Arthritis in Comparison with Methotrexate Monotherapy

DOI Web Site 4 Citations 26 References
  • Miwa Yusuke
    Division of Rheumatology and Clinical Immunology, Showa University school of Medicine
  • Hosaka Michio
    Katsuyama clinic
  • Matsushima Daisuke
    Katsuyama clinic
  • Wakabayashi Kuninobu
    Division of Rheumatology and Clinical Immunology, Showa University school of Medicine
  • Odai Tsuyoshi
    Division of Rheumatology and Clinical Immunology, Showa University school of Medicine
  • Matsunawa Mizuho
    Division of Rheumatology and Clinical Immunology, Showa University school of Medicine
  • Yajima Nobuyuki
    Division of Rheumatology and Clinical Immunology, Showa University school of Medicine
  • Negishi Masao
    Division of Rheumatology and Clinical Immunology, Showa University school of Medicine
  • Ide Hirotsugu
    Division of Rheumatology and Clinical Immunology, Showa University school of Medicine
  • Kasama Tsuyoshi
    Division of Rheumatology and Clinical Immunology, Showa University school of Medicine
  • Adachi Mitsuru
    Division of Rheumatology and Clinical Immunology, Showa University school of Medicine

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Other Title
  • Infliximab治療はmethotrexate単独治療と比較してより強力に関節リウマチ患者の抑うつ状態を改善する
  • Infliximab チリョウ ワ methotrexate タンドク チリョウ ト ヒカクシテ ヨリ キョウリョク ニ カンセツ リウマチ カンジャ ノ ヨクウツ ジョウタイ オ カイゼンスル

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Abstract

Objective : Depression is known to be an important complication in patients with rheumatoid arthritis (RA). Availability of Infliximab (Ifx) treatment for RA is high. Therefore we determined whether depressive states of RA patients are improved by Ifx treatment. Method : We performed Self-rating Depression Scales (SDS) and disease activity score 28 (DAS28 ESR4) to 10 RA patients using Ifx treatment before and after treatment for 2,6,14,22 and 30 weeks. We compared SDS with DAS28 before and after Ifx treatment and reviewed. Nineteen patients started methotrexate (MTX) monotherapy as a control group. Analysis methods included repeated measure analysis of variance (ANOVA) , Mann-Whitney's U test and Fisher's exact probability test by Stat View, ver5.0 (SAS company Co. Ltd.). Results : No significant difference was found in the two groups as to age, sex and dosage of steroid by Mann-Whitney's U test and Fisher's exact probability test. SDS and DAS28 before treatment also showed no significant difference in the two groups. Comparison of SDS in the two groups showed no interaction (p=0.779) in both groups and variation between individuals and intra-subject variation showed significant difference (p=0.006 and p=0.001) according to the repeated measure analysis of variance (ANOVA). However when DAS28 was compared in the two groups, interaction was found (p=0.001). Not yet being scientifically accurate, Ifx showed no significant difference in variation between individuals (p=0.456), but significant difference in intra-subject variation (p=0.001). Conclusion : Although this is a pilot study, it is suggested that Ifx may improve depressive state by decreasing disease activities of RA by way of direct action to the central nerve system.

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