title: [Efficacy of tacrolimus for joint destruction in rheumatoid arthritis].
abstract: Since joint destruction, the most important problem in rheumatoid arthritis (RA) , progress rapidly at the onset of the disease, initial treatment using appropriate disease-modifying anti-rheumatic drug DMARD such as methotrexate (MTX) is strongly recommended in order to retard progression of joint damage. However, not a few patients are resistant to MTX and/or intolerant of MTX. Oral tacrolimus 1.5-3 mg/day, an immunosuppressive drug, was approved in Japan for the treatment of RA insufficient to other DMARD. The properties of tacrolimus have the much potential of inhibition of T cell activation, suppressing the production of pro-inflammatory cytokines, improvement of joint inflammation, retarding bone and cartilage destruction, overcoming drug-resistance and so on and, thereby, tacrolimus can be the best alternative to MTX and biologics in RA patients who are refractory to or intolerant of these other drugs.
authors.affiliation: University of Occupational and Environmental Health, School of Medicine, The First Department of Internal Medicine.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Katsunori
authors.initials: K
authors.lastname: Suzuki
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Saito
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D019703:Calcineurin; D002986:Clinical Trials as Topic; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000494:pharmacology; D007376:Interleukin-2; D007596:Joints / Q000473:pathology*; D008213:Lymphocyte Activation; D050778:NFATC Transcription Factors; D013601:T-Lymphocytes / Q000276:immunology; D016559:Tacrolimus / Q000008:administration & dosage* / Q000494:pharmacology
chemical_list: D007166:Immunosuppressive Agents; D007376:Interleukin-2; D050778:NFATC Transcription Factors; D019703:Calcineurin; D016559:Tacrolimus