slow-acting antirheumatic drug

抗リウマチ薬

WordNet

1. not moving quickly; taking a comparatively long time; "a slow walker"; "the slow lane of traffic"; "her steps were slow"; "he was slow in reacting to the news"; "slow but steady growth"
2. cause to proceed more slowly; "The illness slowed him down" (同)slow down, slow up
3. become slow or slower; "Production slowed" (同)slow down, slow up, slack, slacken
4. (used of timepieces) indicating a time earlier than the correct time; "the clock is slow"
5. at a slow tempo; "the band played a slow waltz"
6. use recreational drugs (同)do drugs
7. administer a drug to; "They drugged the kidnapped tourist" (同)dose
8. a substance that is used as a medicine or narcotic
9. the performance of a part or role in a drama (同)playing, playacting, performing
10. serving temporarily especially as a substitute; "the acting president"
11. one of the proteins into which actomyosin can be split; can exist in either a globular or a fibrous form

PrepTutorEJDIC

1. (速度・動作などが)『遅い』,のろい / 《補語または名詞の後にのみ用いて》(時計などが)『遅れている』 / 『ゆったりした』,あわてない / (人が)理解の遅い,頭の鈍い / (生活・パーティーなどが)『活気のない』,おもしろくない / 遅く,ゆっくり(slowly) / 『遅くなる』,速度を落とす《+『down』(『up』)》 / …‘を'『遅くする』,‘の'速度を落とす《+『名』+『down』(『up』),+『down』(『up』)+『名』》
2. 『薬』,薬品,薬剤 / 『麻薬』,麻酔剤 / 〈人〉‘に'薬(特に麻酔剤)を与える / 〈飲食物〉‘に'(麻酔薬・毒薬などの)薬を混ぜる
3. 代理の,臨時の / 演出用の / 演出,演技
4. 純蛋白質(筋肉生成に役立つ)

UpToDate Contents

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• 1. リウマチ性疾患に用いる免疫抑制剤と従来型の（非生物学的製剤の）疾患修飾性抗リウマチ薬の概要 overview of immunosuppressive and conventional non biologic disease modifying drugs in the rheumatic diseases
• 2. 初回の非生物学的DMARD療法に耐性を示す成人における関節リウマチの治療 treatment of rheumatoid arthritis in adults resistant to initial nonbiologic dmard therapy
• 3. リウマチ性疾患のマネージメントに用いる生物学的製剤とキナーゼ阻害薬の概要 overview of biologic agents and kinase inhibitors in the rheumatic diseases
• 4. 成人における関節リウマチのマネージメントの一般的原則 general principles of management of rheumatoid arthritis in adults
• 5. 初回の生物学的DMARD療法に耐性を示す成人における関節リウマチの治療 treatment of rheumatoid arthritis in adults resistant to initial biologic dmard therapy

English Journal

• Tocilizumab: new drug. Rheumatoid arthritis: another 'mab', no therapeutic advantage.

• [No authors listed]Abstract(1) First-line disease-modifying treatment for rheumatoid arthritis is based on "slow-acting" antirheumatic agents, generally methotrexate. Subsequent options include a TNF-alpha antagonist, followed by rituximab or possibly abatacept; (2) Tocilizumab, a monoclonal antibody, inhibits interleukin-6 receptors. It is licensed in the European Union for patients with rheumatoid arthritis in whom other drugs have failed; (3) Clinical evaluation includes 4 placebo-controlled trials of the methotrexate-tocilizumab combination, after failure of a slow-acting antirheumatic drug (3 trials) or failure of a slow-acting antirheumatic drug and a TNF-alpha antagonist (1 trial). An indirect comparison suggests that tocilizumab is no more effective than rituximab in patients with multiple treatment failure; (4) Tocilizumab, like TNF-alpha antagonists, is an immunosuppressant. It carries a risk of serious infections, haematological disorders (neutropenia, thrombocytopenia), gastrointestinal bleeding, hepatic disorders, and systemic and local reactions during the infusion; (5) the adverse effects of long-term tocilizumab therapy are unknown, particularly the risk of cancer; (6) Tocilizumab carries a risk of interactions with drugs that are metabolised by cytochrome P450 isoenzymes. Clinical consequences cannot be ruled out when co-administered drugs have a narrow therapeutic margin; (7) Tocilizumab is administered intravenously every 4 weeks, making it slightly more convenient that rituximab at the beginning of treatment; (8) In patients with rheumatoid arthritis and multiple treatment failure, it remains to be shown whether tocilizumab has a better risk-benefit balance than rituximab, a drug with which we have more experience. It is therefore better to continue to use rituximab, or possibly abatacept.
• Prescrire international.Prescrire Int.2009 Oct;18(103):198-201.
• (1) First-line disease-modifying treatment for rheumatoid arthritis is based on "slow-acting" antirheumatic agents, generally methotrexate. Subsequent options include a TNF-alpha antagonist, followed by rituximab or possibly abatacept; (2) Tocilizumab, a monoclonal antibody, inhibits interleukin-6 r
• PMID 19882783

• Safety and efficacy of combination of etanercept and methotrexate compared to treatment with etanercept only in patients with juvenile idiopathic arthritis (JIA): preliminary data from the German JIA Registry.

• Horneff G, De Bock F, Foeldvari I, Girschick HJ, Michels H, Moebius D, Schmeling H; German and Austrian Paediatric Rheumatology Collaborative Study Group.Collaborators (34)Hospach A, Urban A, Linde T, Nimtz-Talaska A, Borte M, Niehues T, Heubner A, Berger T, Neudorf U, Brunner J, Baan A, Mokross C, Weissbarth-Riedel E, Zimmermann O, Terschluse K, Moller J, Sailer-Hock M, Ganser G, Benseler S, Kornbrust A, Heubner G, Gahr M, Huocke C, Huppertz I, Ehl S, Schofer O, Thon A, Roth J, Keitzer R, Kummerle-Deschner J, Tzaribachev N, Kuster RM, Quietzsch J, Mathony K.
• Annals of the rheumatic diseases.Ann Rheum Dis.2009 Apr;68(4):519-25. Epub 2008 Apr 15.
• OBJECTIVE: Etanercept monotherapy has been studied and approved for treatment of polyarticular juvenile idiopathic arthritis (JIA). The following study evaluates the safety and efficacy of combination therapy of etanercept and methotrexate compared to etanercept monotherapy in JIA.METHODS: We perfom
• PMID 18413440

Japanese Journal

• A 15-year follow-up study on the outcome in patients with early rheumatoid arthritis

• MIYAGI KENICHI,AZUMA TAKESHI,NAITOH AKIFUMI,SAKAIDA HIROYUKI,SAKATA MOROMICHI,NAKAGAWA TAKEMASA,MIYAHARA HIDEO,SHIRATAKA MASUO
• Japanese journal of rheumatology 8(2), 117-129, 1998-06-01
• NAID 10016289862

Related Links

• Clinical pharmacokinetics of slow-acting antirheumatic drugs.

The pharmacokinetics of the slow acting antirheumatic drugs (SAARDs), hydroxychloroquine, chloroquine, penicillamine, the gold complexes and sulphasalazine, in humans have been studied. For all these drugs, both in controlled clinical ...

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★リンクテーブル★

リンク元	「抗リウマチ薬」
関連記事	「slow」「slowing」「drug」

「抗リウマチ薬」

　　[★]

英

antirheumatic drug

同

疾患修飾性抗リウマチ薬 disease-modifying antirheumatic drug DMARD、遅効性抗リウマチ薬 slow-acting antirheumatic drug SAARD

関

定義

• 1. 関節リウマチの治療薬であって、関節破壊を抑制する薬剤のことを指す(出典不明)

• 遅効性：一般的にこれらの薬剤は効果が出るまでに数ヶ月要する(別名：SAARDs, slow-acting antirheumatic drugs, 遅効性抗リウマチ薬)。

• 2. 関節リウマチの治療薬のこと。金剤、D-ペニシラミンなど。DMARDsとも呼ばれる(REU.66)

• 免疫抑制薬は、抗リウマチ薬が奏功しない、あるいは疾患の活動性が高いときに切り札的に用いられるが、これを抗リウマチ薬にふくめるかどうかは謎。(REU.66では抗リウマチ薬に含めていない)

• 3. http://en.wikipedia.org/wiki/Disease-modifying_antirheumatic_drug

• Disease-modifying antirheumatic drugs (DMARDs) is a category of otherwise unrelated drugs defined by their use in rheumatoid arthritis to slow down disease progression. The term is often used in contrast to non-steroidal anti-inflammatory drug, which refers to agents that treat the inflammation but not the underlying cause.
• The term "antirheumatic" can be used in similar contexts, but without making a claim about an effect on the course.

抗リウマチ薬はRAの進行を抑えるかどうかは問わない。抗リウマチ薬の下位概念としてDMARDがある(NSAIDsも含まれると考えて良いだろう)。DMARDはNSAIDsを待避させた概念か。

抗リウマチ薬 (リウマチ ガイドライン？より)

薬剤			抗リウマチ作用	注意すべき副作用
免疫調節薬	金製剤	金チオリンゴ酸ナトリウム	中	皮疹， 蛋白尿
		オーラノフィン	弱	下痢・軟便
	D-ペニシラミン		中	皮疹， 蛋白尿， 肝障害， 血小板減少， 自己免疫疾患の誘発
	サラゾスルファピリジン SSZ		中	皮疹
	ブシラミン		中	皮疹， 蛋白尿
	ロベンザリット		弱	腎機能障害
	アクタリット		弱	皮疹
免疫抑制薬		メトトレキサート MTX	強	間質性肺炎， 骨髄障害， 肝障害
		ミゾリビン	弱	高尿酸血症
		レフルノミド LEF	強	肝障害， 骨髄障害，下痢， 感染症， 間質性肺炎
		アザチオプリン	弱	肝障害， 白血球減少
		シクロホスファミド	弱	骨髄障害， 出血性膀胱炎
		シクロスポリン	中	腎障害， 高血圧， 耐糖能異常
		タクロリムス	中	腎障害， 高血圧， 耐糖能異常

抗リウマチ薬の薬剤性肺障害

• メトトレキサート　：◎
• ブシラミン　：○
• サラゾスルファピリジン　：△
• レルフノミド　：◎
• 金チオリンゴ酸ナトリウム　：○
• D-ペニシラミン　：△

副作用

• 出現率：50%
• 皮疹、口内炎、脱毛
• 胃腸障害、味覚障害
• 間質性肺炎
• 骨髄抑制
• 肝機能障害
• 蛋白尿

「slow」

　　[★]

• adj.

• (比較級slower-最上級slowest)緩徐な、遅い、ゆっくりとした、緩慢な

• v.

• 遅くする

関

gradual、gradually、late、slowly、sluggish

　 　 　 　 　 　

「slowing」

　　[★]

• n.

• 緩徐化、徐脈化

「drug」

　　[★]

同

drugs