インフリキシマブが奏効した乾癬性関節炎の1例

Infliximab Therapy for Psoriatic Arthritis. Case Report

　インフリキシマブ(infliximab：IFX)が有用であった乾癬性関節炎(psoriatic arthritis：PsA)の1例を経験した．症例は53歳の男性で，四肢・体幹の隆起性紅斑と多関節炎を主訴とし，当院を受診した．PsAと診断し，シクロスポリンと塩酸エピナスチン，NSAIDsの投与を行ったが，寛解は得られなかった．IFXの投与により，関節炎と紅斑はほぼ消失し，Disease Activity Score (DAS) 28-CRPが4.70から1.52に低下した．Psoriasis Activity and Severity Index(PASI)スコアは37から2.4に低下した．関節リウマチ同様，コントロール不良のPsAに対し，生物学的製剤の使用を積極的に検討すべきである．

　We report a case of psoriatic arthritis (PsA) treated with Infliximab (IFX).　The patient was a 53-year-old man who complained of polyarthralgia and a widespread skin eruption and was diagnosed with PsA.　He was treated with epinastine hydrochloride, cyclosporine, and nonsteroidal anti-inflammatory drugs (NSAIDs), but a remission was not achieved.　We then treated him with 5 mg/kg IFX intravenously at week 0, 2, 6, 8, 16, and 24.　After 2 weeks of IFX therapy, his Disease Activity Score based on C-reactive protein (DAS28-CRP) had decreased from 4.70 to 1.52, and after 10 weeks of treatment his Psoriasis Activity and Severity Index (PASI) score had decreased from 37 to 2.4.　Treatment with IFX for 24 weeks significantly improved the patient's active PsA, including his polyarthralgia and widespread skin eruption.

　IFX therapy should be considered for patients with active PsA that is unresponsive to conventional methods of treatment.