title: Inhibitory effect of tacrolimus on progression of joint damage in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To examine the inhibitory effect of tacrolimus on radiographic joint damage in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Thirty-eight patients with RA resistant or intolerant to conventional disease-modifying anti-rheumatic drugs were administered tacrolimus and analyzed retrospectively. Disease activity and clinical response were evaluated by Disease Activity Score in 28 joints and C-reactive protein (DAS28-CRP) and European League Against Rheumatism (EULAR) response criteria. The progression of joint destruction was evaluated by an estimated yearly change in modified Total Sharp Score (mTSS).
  
  
  RESULTS
  Good or moderate response rate according to EULAR response criteria was seen in 63.2%, 63.2%, 73.7% and 65.8% of patients at 3, 6, 12, and 24 months, respectively. The rate of patients with low disease activity or remission reached 47.3% and 50.0% at 12 and 24 months, respectively. Progression of joint damage, evaluated as yearly change in mTSS (ΔmTSS), significantly decreased from 11.4 at baseline to 2.63 in the first year and 0.69 in the second year of tacrolimus treatment.
  
  
  CONCLUSIONS
  These findings suggest tacrolimus has the potential to inhibit progression of joint damage in established RA.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan.
authors.forename: Hiraku
authors.initials: H
authors.lastname: Motomura
authors.forename: Isao
authors.initials: I
authors.lastname: Matsushita
authors.forename: Eiko
authors.initials: E
authors.lastname: Seki
authors.forename: Hayato
authors.initials: H
authors.lastname: Mine
authors.forename: Tomoatsu
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001175:Arthrography; D018450:Disease Progression; D005260:Female; D006801:Humans; D007596:Joints / Q000187:drug effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016559:Tacrolimus / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D016559:Tacrolimus
keywords: joint damage; mTSS; rheumatoid arthritis; tacrolimus