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関節リウマチ(RA)の注入療法の実態調査を行った報告はほとんどない.そこで,関節内注入療法の実態を検討する目的で,前向きの調査を行った.対象は4,998名のRA患者で,回答率は83%であった.関節内注入療法を受けた症例は,過去6カ月間で587名(14.1%)であり,CRP,血沈,HAQ,DAS28が高く,RAの疾患活動性の高い症例に注入される傾向を認めた.注入部位は,膝,肩の順であった.注入頻度は,3~6回が最も高い結果となった.使用薬剤はステロイド43%,ヒアルロン酸37.4%であり,薬剤別満足度は,ステロイドでは56.8であり,ヒアルロン酸は54.7という結果を得た.
Intra-articular injections of corticosteroid and hyaluronate are useful tools for the treatment of osteoarthritis of the knee, and although the therapeutic efficacy of intra-articular corticosteroid injections has been established in rheumatoid arthritis, the most immediate form of evidence available for the clinical efficacy of intra-articular sodium hyaluronate is debatable. We therefore tried evaluating the clinical efficacy of intra-articular corticosteroid and hyaluronate injections by analyzing the patient database from a long-term, prospective, observational cohort study of IORRA. The cross-sectional analysis revealed a corticosteroid rate of 56.8 versus 54.7 for hyaluronate. No significant difference between the clinical efficacy of corticosteroid and hyaluronate injections was found in rheumatoid arthritis patients based on these data.
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