{"id":2494,"date":"2023-12-06T16:18:41","date_gmt":"2023-12-06T07:18:41","guid":{"rendered":"https:\/\/www.hcfm.jp\/journal\/?p=2494"},"modified":"2023-12-20T17:54:01","modified_gmt":"2023-12-20T08:54:01","slug":"%e9%ab%98%e9%bd%a2%e8%80%85%e3%81%aera%e6%82%a3%e8%80%85%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e4%bd%8e%e5%ae%b9%e9%87%8f%e3%83%97%e3%83%ac%e3%83%89%e3%83%8b%e3%82%be%e3%83%ad%e3%83%b3%e3%81%ae%e8%bf%bd","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2494","title":{"rendered":"\u9ad8\u9f62\u8005\u306eRA\u60a3\u8005\u306b\u304a\u3051\u308b\u4f4e\u5bb9\u91cf\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u306e\u8ffd\u52a0\u52b9\u679c"},"content":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat\u2019s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002<\/p>\n

\uff0d\u6587\u732e\u540d\uff0d
\n\u30fbBoers M, Hartman L, Opris-Belinski D, et al.
\n\u201cLow dose, add-on prednisolone in patients with rheumatoid arthritis aged 65+: the pragmatic randomised, double-blind placebo-controlled GLORIA trial.\u201d
\n\u30fbAnnals of the Rheumatic Diseases 2022;81:925-936.<\/p>\n

\uff0d\u8981\u7d04\uff0d
\nBackground\uff1a
\nRA\u306f\u708e\u75c7\u6027\u75be\u60a3\u3067\u3042\u308a\u3001RA\u305d\u306e\u3082\u306e\u3001\u3042\u308b\u3044\u306f\u6cbb\u7642\u306b\u3088\u308a\u5408\u4f75\u75c7\u3092\u751f\u3058\u308b\u3002\u30b0\u30eb\u30b3\u30b3\u30eb\u30c1\u30b3\u30a4\u30c9\u306b\u3088\u308b\u6cbb\u7642\u306f1950\u5e74\u3088\u308a\u6bd4\u8f03\u7684common\u306b\u884c\u308f\u308c\u3066\u3044\u308b\u304c\u3001\u305d\u306e\u30e1\u30ea\u30c3\u30c8\u3068\u30c7\u30e1\u30ea\u30c3\u30c8\u306f\u307e\u3060\u3088\u304f\u308f\u304b\u3063\u3066\u3044\u306a\u3044\u3002\u591a\u304f\u306f\u30b9\u30c6\u30ed\u30a4\u30c9\u306b\u3088\u308b\u526f\u4f5c\u7528\u306e\u61f8\u5ff5\u304c\u3042\u308b\u304c\u3001\u521d\u671f\u306eRA\u306b\u3064\u3044\u3066\u306f\u5408\u4f75\u75c7\u304c\u76ee\u7acb\u305f\u306a\u3044\u3068\u3044\u3046\u5831\u544a\u3082\u3042\u308b\u3002
\n\u591a\u304f\u306e\u7814\u7a76\u3067\u306f\u3088\u308a\u5408\u4f75\u75c7\u3092\u7d4c\u9a13\u3057\u3084\u3059\u3044\u9ad8\u9f62\u8005\u304c\u9664\u5916\u3055\u308c\u3066\u3044\u305f\u308a\u3001PSL\u306e\u91cf\u304c\u30d0\u30e9\u30d0\u30e9\u3067\u3042\u3063\u305f\u308a\u3068\u8cea\u306e\u9ad8\u3044\u7814\u7a76\u306f\u884c\u308f\u308c\u3066\u3044\u306a\u3044\u3002
\n\u305d\u3053\u3067\u3001\u4eca\u56de\u306f2\u5e74\u306e\u76f2\u691c\u5316\u6bd4\u8f03\u8a66\u9a13\uff08GLORIA\uff09\u306b\u3088\u308a\u3001\u9ad8\u9f62\u8005\u306b\u304a\u3044\u3066\u30015mg\/\u65e5\u306ePSL\u3092\u6a19\u6e96\u6cbb\u7642\u306b\u52a0\u3048\u305f\u52b9\u679c\u3068\u5b89\u5168\u6027\u306b\u3064\u3044\u3066\u691c\u8a0e\u3059\u308b\u3002<\/p>\n

Method\uff1a
\n\u30c7\u30b6\u30a4\u30f3\u3001\u30bb\u30c3\u30c6\u30a3\u30f3\u30b0\uff1aEU\u306e7\u30ab\u56fd\u300128\u65bd\u8a2d\u3067\u7121\u4f5c\u70ba\u3001\u4e8c\u91cd\u76f2\u691c\u306eRCT\u3002
\nPSL5mg\u7fa4\u3068\u30d7\u30e9\u30bb\u30dc\u7fa4\u3092\u3001\u904e\u53bb\u306ePSL\u4f7f\u7528\u6b74\u3001\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306e\u30ea\u30a6\u30de\u30c1\u6cbb\u7642\u3001\u65bd\u8a2d\u306b\u3088\u3063\u3066\u5c64\u5225\u5316\u3057\u30661:1\u306b\u5272\u308a\u4ed8\u3051\u3001\u7d4c\u904e\u4e2d\u306e\u6297\u30ea\u30a6\u30de\u30c1\u85ac\u3084\u30d5\u30ec\u30a2\u6642\u306e\u77ed\u671f\u9593\u306e\u5f37\u5316\u6cbb\u7642\u306a\u3069\u306f\u884c\u3063\u305f\u3002\uff08\u306f\u3058\u3081\u306e3\u30f6\u6708\u306f\u306a\u308b\u3079\u304f\u6297\u30ea\u30a6\u30de\u30c1\u85ac\u306f\u5909\u66f4\u3057\u306a\u3044\u3088\u3046\u306b\u304a\u9858\u3044\u3057\u305f\uff09<\/p>\n

\u5bfe\u8c61\u60a3\u8005\uff1a65\u6b73\u4ee5\u4e0a\u306eRA\u60a3\u8005\u3067DAS28 2.6\u4ee5\u4e0a(\u5f53\u521d\u306f3.2\u4ee5\u4e0a\u3000\u4f4e\u30fb\u4e2d\u6d3b\u52d5\u6027\u4ee5\u4e0a)
\n\u9664\u5916\u57fa\u6e96\uff1b\u30b9\u30c6\u30ed\u30a4\u30c9\u6cbb\u7642\u306e\u7981\u5fcc\u3001\u6cbb\u7642\u306b\u3088\u308a\u60aa\u5f71\u97ff\u304c\u3042\u308b\u3068\u8003\u3048\u3089\u308c\u308b\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u4e0d\u826f\u306e\u72b6\u614b\u3002
\n\u30a2\u30a6\u30c8\u30ab\u30e0\u8a55\u4fa1\uff1a\u8eab\u4f53\u691c\u67fb\u3068\u5b9a\u671f\u7684\u306a\u63a1\u8840\u3092\u5fc5\u8981\u3068\u3059\u308b\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u3001\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u30013\u30016\u300112\u300118\u300124\u30f6\u6708\u76ee\u306b\u8a55\u4fa1\u3057\u305f\u3002\u60a3\u8005\u306f\u3053\u308c\u3089\u306e\u6642\u671f\u306b\u8ee2\u5e30\u3092\u5831\u544a\u3057\u3001\u3055\u3089\u306b9\u300115\u300121\u30f6\u6708\u76ee\u306b\u96fb\u8a71\u30a4\u30f3\u30bf\u30d3\u30e5\u30fc\u3092\u884c\u3063\u305f\u3002\u753b\u50cf\u8a3a\u65ad\u306f\u3001\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306824\u30f5\u6708\u76ee\u306b\u5b9f\u65bd\u3057\u305f\u3002
\n\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\uff1a\u6709\u76ca\u6027\u306e\u4e3b\u8981\u8a55\u4fa1\u9805\u76ee\uff1aDAS28\uff08\u6b20\u6e2c\u306f\u591a\u91cd\u88dc\u5b8c\uff09
\n\u6709\u5bb3\u6027\u306e\u4e3b\u8981\u8a55\u4fa1\u9805\u76ee\uff1a\u7279\u306b\u6ce8\u76ee\u3059\u3079\u304d\u6709\u5bb3\u4e8b\u8c61\uff08AESI\uff09\u30921\u3064\u4ee5\u4e0a\u7d4c\u9a13\u3057\u305f\u60a3\u8005\u6570\u306e\u5408\u8a08
\nAESI\u306b\u306f\u3001Good Clinical Practice\u306e\u5b9a\u7fa9\u306b\u5f93\u3063\u305f\u91cd\u7be4\u306aAE\uff08SAE\uff09\u3001\u4ee5\u4e0b\u306e\u3082\u306e\u3092\u52a0\u3048\u305f\u3082\u306e\u3092\u5b9a\u7fa9\u3068\u3057\u305f(Other AESI)\u3002
\nAESI
\n1. \u6cbb\u7642\u7d99\u7d9a\u304c\u56f0\u96e3\u306a\u6709\u5bb3\u4e8b\u8c61
\n2. \u5fc3\u7b4b\u6897\u585e\u3001\u8133\u5352\u4e2d\u3001PAD
\n3. \u65b0\u898f\u767a\u75c7\u3000\uff08\u9ad8\u8840\u5727\u3001\u7cd6\u5c3f\u75c5\u3001\u611f\u67d3\u75c7\u3001\u767d\u5185\u969c\u3001\u7dd1\u5185\u969c\uff09
\n4. \u75c7\u72b6\u306e\u3042\u308b\u9aa8\u6298<\/p>\n

\"\"<\/a><\/p>\n

\u526f\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\uff1a\u624b\u8db3\u306e\u30ec\u30f3\u30c8\u30b2\u30f3\u4e0a\u306e\u9aa8\u7834\u58ca\u3001DEXA (complete case)
\n\u30b5\u30f3\u30d7\u30eb\u30b5\u30a4\u30ba:800\u4eba\u3001\u30d9\u30fc\u30b9\u306e\u6709\u5bb3\u4e8b\u8c61\u309220%\u3068\u3057\u3066\u300127.5%\u307e\u3067\u306e\u4e0a\u6607\u309280%\u691c\u51fa\u3067\u304d\u308b\uff09
\n \u3000\u3000\u3000\u3000\u3000\u3000\u3000COVID\u306b\u3088\u308a\u4e88\u5b9a\u3088\u308a\u52df\u96c6\u304c\u96c6\u307e\u3089\u306a\u304b\u3063\u305f\u304c450\u4eba\u3067\u3082\u554f\u984c\u306a\u3044\u3053\u3068\u3092\u5225\u306e\u7814\u7a76\u3067\u78ba\u8a8d\u3057\u305f\u3002
\n\u7d71\u8a08\u89e3\u6790\uff1bR, SPSS \u3001Excel<\/p>\n

Results\uff1a
\n\u30d5\u30ed\u30fc\u30c1\u30e3\u30fc\u30c8
\n\u5408\u8a08451\u4eba\u30ea\u30af\u30eb\u30fc\u30c8\u3057\u3001\u30b3\u30f3\u30d7\u30ea\u30fc\u30c8\u3057\u305f\u306e\u306f6\u5272\u524d\u5f8c\u305a\u3064\uff0820%\u306fCOVID\u95a2\u9023\u306e\u30a2\u30af\u30bb\u30b9\u306e\u554f\u984c\u306b\u3088\u308b\u8131\u843d\uff09<\/p>\n

\"\"<\/a>
\n\"\"<\/a>
\n\uff08\u57fa\u672c\u5c5e\u6027\uff09
\n\u5e73\u5747\u5e74\u9f6272\u6b73\u3001BMI27\u3002DAS28\u306f\u9ad8\u75be\u60a3\u6d3b\u52d5\u6027\u3001CCP\u967d\u6027\u304cPSL\u7fa4\u306b\u3084\u3084\u591a\u3044\u3002<\/p>\n

\u30fb\u6709\u52b9\u6027\u306e\u6307\u6a19\uff08DAS28\uff09
\n\"\"<\/a><\/p>\n

\u7279\u306b\u306f\u3058\u3081\u306e3\u30f6\u6708\u306f\u75be\u60a3\u6d3b\u52d5\u6027\u306e\u4f4e\u4e0b\u304cPSL\u7fa4\u306f\u9855\u8457\u3060\u3063\u305f\u3002
\n\"\"<\/a>
\nSDAI\u3001\u30ec\u30b9\u30dd\u30f3\u30b9\u3001\u306a\u3069\u5168\u4f53\u7684\u306bPSL\u7fa4\u304c\u826f\u3044\u5370\u8c61\u3002
\n\"\"<\/a><\/p>\n

\u30fb\u5b89\u5168\u6027\u306e\u30a2\u30a6\u30c8\u30ab\u30e0
\n\"\"<\/a><\/p>\n

\u4e3b\u306b\u611f\u67d3\u75c7\u306e\u6709\u5bb3\u4e8b\u8c61\u306f\u5897\u3048\u3066\u3044\u308b\u3002\u9aa8\u6298\u304c\u5168\u4f53\u306f\u5897\u3048\u3066\u3044\u308b\u304c\u3001SAE\u306f\u5c11\u306a\u3044\u3002
\n\"\"<\/a><\/p>\n

Discussion\uff1a\u4eca\u56de\u306e\u7814\u7a76\u306e\u9650\u754c\u3001\u6b8b\u3055\u308c\u305f\u8ab2\u984c\u306a\u3069\u3092\u8a18\u8f09\u3059\u308b\u3002
\n\u6cbb\u7642\u306e\u6700\u9069\u5316\u304c\u53ef\u80fd\u306a\u6a19\u6e96\u6cbb\u7642\u3092\u53d7\u3051\u305f 65 \u6b73\u4ee5\u4e0a\u306e RA \u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u4f4e\u7528\u91cf\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3 \u306e\u8ffd\u52a0\u6295\u4e0e\u306f\u3001\u75be\u60a3\u6d3b\u52d5\u6027\u3068\u640d\u50b7\u306e\u9032\u884c\u306b\u9577\u671f\u7684\u306b\u6709\u76ca\u306a\u52b9\u679c\u3092\u793a\u3057\u305f\u3002\u3057\u304b\u3057\u3001\u305d\u306e\u4ee3\u511f\u3068\u3057\u3066\u3001\u5c11\u306a\u304f\u3068\u30821\u3064\u306eAESI\u3092\u6709\u3059\u308b\u60a3\u8005\u6570\u304c11\uff05\u5897\u52a0\u3057\u305f\u3002\u305d\u306e\u307b\u3068\u3093\u3069\u304c\u3001\u611f\u67d3\u75c7\u3067\u3042\u3063\u305f\u3002
\n\u30d0\u30a4\u30aa\u3092\u4f7f\u7528\u3057\u3066\u3044\u308b\u60a3\u8005\u306f\u6bd4\u8f03\u7684\u8af8\u5916\u56fd\u3068\u6bd4\u3079\u3066\u5c11\u306a\u3044\u5730\u57df\u3067\u3082\u3042\u308a(20%)\u3001\u30d0\u30a4\u30aa\u3068\u4f75\u7528\u3057\u305f\u5834\u5408\u306e\u518d\u71c3\u4e88\u9632\u3001\u611f\u67d3\u75c7\u306e\u30ea\u30b9\u30af\u306b\u3064\u3044\u3066\u306f\u4e0d\u660e\u3067\u3042\u308b\u3002
\n\u9577\u6240\u306f\u30b5\u30f3\u30d7\u30eb\u30b5\u30a4\u30ba\u3001\u9ad8\u9f62\u8005\u3092\u30bf\u30fc\u30b2\u30c3\u30c8\u3068\u3057\u305f\u3053\u3068\u3001\u8a73\u7d30\u306a\u6709\u5bb3\u4e8b\u8c61\u306e\u8a18\u9332\u3067\u3042\u308b\u3002
\n\u77ed\u6240\u306f\u30e2\u30c7\u30eb\u7684\u306b\u904e\u5c0f\u8a55\u4fa1\u3059\u308b\u30c7\u30b6\u30a4\u30f3\u3060\u3063\u305f\u3053\u3068\u3001\u30d7\u30e9\u30bb\u30dc\u304c\u5224\u5225\u4e0d\u80fd\u306b\u306a\u3063\u3066\u3044\u305f\u304b\u3069\u3046\u304b\u3001\u77ed\u671f\u306e\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u306a\u306e\u3067\u3088\u308a\u9577\u671f\u306e\u6709\u5bb3\u4e8b\u8c61\u306b\u3064\u3044\u3066\u306f\u4e0d\u660e\u306a\u3053\u3068\u3067\u3042\u308b\u3002
\n\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\u3001\u77ed\u671f\u306ePSL\u306e\u4f7f\u7528\u3092\u63a8\u5968\u3057\u3066\u3044\u308b\u4e00\u65b9\u3067\u3001\u5b9f\u969b\u306b\u306f\u9577\u671f\u7684\u306b\u4f4e\u5bb9\u91cf\u306ePSL\u304c\u30d7\u30e9\u30af\u30c6\u30a3\u30b9\u3068\u3057\u3066\u3055\u308c\u3066\u3044\u308b\u3002\u4eca\u56de\u306e\u7d50\u679c\u3067\u3042\u308c\u3070\u3001\u9069\u5207\u306a\u30e2\u30cb\u30bf\u30ea\u30f3\u30b0\u3001\u6709\u5bb3\u4f5c\u7528\uff08\u7279\u306b\u611f\u67d3\u75c7\u3084\u9aa8\u91cf\u6e1b\u5c11\uff09\u306e\u4e88\u9632\u3068\u6cbb\u7642\u3092\u884c\u3048\u3070\u3001\u3053\u306e\u30ec\u30d9\u30eb\u3067\u6f38\u5897\u3059\u308c\u3070\u3001\u75be\u60a3\u6d3b\u52d5\u6027\u3092\u6700\u9069\u306b\u6291\u5236\u3059\u308b\u3053\u3068\u304c\u53ef\u80fd\u3067\u3042\u308b\u3002
\n\u7d50\u8ad6\u3068\u3057\u3066\u3001\u4f4e\u7528\u91cf\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u306e\u8ffd\u52a0\u6295\u4e0e\u306f\u3001\u6700\u9069\u306a\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u308b\u9ad8\u9f62\u306eRA\u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u6709\u76ca\u6027\u3068\u6709\u5bb3\u6027\u306e\u30d0\u30e9\u30f3\u30b9\u304c\u826f\u597d\u3067\u3042\u308a\u3001\u9577\u671f\u7684\u306b\u52b9\u679c\u304c\u671f\u5f85\u3067\u304d\u308b\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u30112023\u5e743\u67081\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat\u2019s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002 \uff0d\u6587\u732e\u540d\uff0d \u30fbBoers M, Hartman L, Opris-Belinski … \u7d9a\u304d\u3092\u8aad\u3080 \u9ad8\u9f62\u8005\u306eRA\u60a3\u8005\u306b\u304a\u3051\u308b\u4f4e\u5bb9\u91cf\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u306e\u8ffd\u52a0\u52b9\u679c<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33,17],"tags":[],"class_list":["post-2494","post","type-post","status-publish","format-standard","hentry","category-whats-new","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2494","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2494"}],"version-history":[{"count":3,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2494\/revisions"}],"predecessor-version":[{"id":2516,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2494\/revisions\/2516"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2494"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2494"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2494"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}