最新リウマチ情報
05/13 UFC 262
05/05 Angevine Middle School eighth grader named honoree in this year’s Walk to Cure Arthritis
05/11 Vaccination effective in spite of immune disease
05/11 A Critical Look at Race-based Practices in Rheumatology Guidelines
05/14 Foot Pain Common but Overlooked in RA
05/14 TRACES OF LAUREL: Lot Pitman descendants | Community
05/14 Crumbling mansion dubbed the 'Welsh Versailles' sells to mystery buyer for £950,000
03/27 Rheumatic Arthritis or Rheumatism: How to keep the disease from progressing; tips to keep your mobility intact
05/14 Health and Wellness Market Business Opportunity and Forecast 2021-2026 | Covid-19 Impact Analysis ? The Manomet Current
04/15 UMCG research: junk food, sugar and drink cause intestinal inflammation and thus diabetes and rheumatism (vegetarian food has the opposite effect)
05/10 Free of lockdown, tourists enjoy Turkey’s ‘white paradise’ Pamukkale | Daily Sabah
03/11 Roche rheumatism drug does not reduce Covid-19 deaths
05/12 DentaForce Reviews: Oral Care Ingredients That Work or...
02/12 What is the Difference Between Arthritis and Rheumatism?
11/05 Rheumatism drug could boost effectiveness of antibiotics against superbugs: study
07/17 Inflammatory rheumatism: Types, symptoms, and treatments
05/12 Contentious issues in gout management | OARRR
04/24 Controversy persists for palindromic rheumatism: RA precursor or distinct entity?
03/03 Combo Therapy Boosts Response in Uncontrolled Gout
06/17 EULAR: Early and intensive treatment of rheumatoid arthritis reduces fatigue
09/12 Palindromic rheumatism: What it is, symptoms, and outlook
04/23 Anti-rheumatism drug that also works on COVID-19
11/23 First flare of ACPA-positive rheumatoid arthritis after SARS-CoV-2 infection
06/08 Alpine Immune Sciences Provides Clinical Update of its Phase 1 Trial of ALPN-101 in Healthy Volunteers at the European League Against Rheumatism (EULAR) E-Congress 2020
06/05 EULAR 2020: Thrombosis risk particularly high for people suffering
03/25 COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study
03/30 Helping childhood-onset lupus patients stay healthy as adults
03/03 Cancer drugs shed light on rheumatism
06/09 EULAR advocates deployment of health care professionals -- study confirms effectiveness
07/07 Treatment with methotrexate and risk of lung disease in patients with rheumatoid arthritis
06/17 EULAR 2020: highlights from the European e-Congress of Rheumatology
06/18 Patients with rheumatic disease, COVID-19 more likely to require ventilation
03/16 Expert Advice on Coronavirus Risk in Immunocompromised Patients With Rheumatic Diseases
06/03 Study on COVID-19 and RMD provides reassurance to patients on immunosuppressive medication
11/18 Rheumatism Center / Krampe Schmidt Architects BDA
12/02 Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised, observer blinded clinical trial
06/03 New First-in-Class Phase 3 TREMFYA® (guselkumab) Data Demonstrate Improvement in Psoriatic Arthritis Joint and Skin Symptoms at Week 52
04/03 Palm trees can help cure headaches, rheumatism
04/01 The Prescription for Rheumatism Used to Be to Sit Inside a Rotting Whale for 30 Hours
06/08 Abbvie's Rinvoq matches BMS' Orencia in head-to-head rheumatoid arthritis trial
03/31 Australians bathed inside rotting whales to 'cure' rheumatism
04/20 Rheumatoid Arthritis and Working on the Job
05/15 Rituximab Effectively Treats ‘Forerunner’ of RA
07/23 In Alex Trebek’s reluctant, moving memoir, life is all about the next question
04/16 Rheumatic disease and COVID-19: initial data from the COVID-19 Global Rheumatology Alliance provider registries
07/30 8 hand exercises for arthritis: Pictures and the necessary equipment
10/24 AbbVie draws favorable rating for its rheumatism drug in Europe
08/04 Ankylosing spondylitis (AS): Becoming a mother despite having a rheumatic disease?
12/19 Arthritis, rheumatism and total joint arthroplasty: an interview with Dr Ravi and Dr Hawker
08/26 Rheumatoid Arthritis Diagnosis & Tests: How Doctors Diagnose RA
07/02 Can Copper or Magnetic Bracelets Ease Your Arthritis?
09/11 2019 EULAR/ACR Recommendations for SLE Classification Criteria
04/17 From the throat to the heart: Charting the long history of rheumatic fever
11/06 Rheumatoid Arthritis Complications and Effects on the Body
10/16 Are There Benefits to Drinking Kombucha?
11/07 Why an English Museum Has a Collection of Magic Potatoes
09/05 Pfizer Korea releases new tool for rheumatism injection
07/12 Mary K. Crow, MD, and Jane E. Salmon, MD, Named Honorary Members of the European League Against Rheumatism
10/30 'I Was Diagnosed With Rheumatoid Arthritis at 40-Right After I Had a Baby'
09/04 What is autoimmune arthritis? Symptoms and treatment
06/12 All men with gout should be routinely screened for erectile dysfunction
06/15 Gum disease may be a key initiator of rheumatoid arthritis related autoimmunity: Significantly higher prevalence of gum disease found in individuals at risk of rheumatoid arthritis compared to healthy controls
07/18 EULAR Updates Guidelines for Large Vessel Vasculitis
11/19 Start Treatment Early in RA, Even in Seronegatives
06/11 Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days
06/10 One third of rheumatoid arthritis patients experience sexual dysfunction
07/25 Did you know orchids can cure rheumatism?
03/30 Bizarre whale treatment for rheumatism revealed
03/16 Rheuminations: Blame the Pain on the Rain? | MedPage Today
06/17 Triple Therapy as Good as Biologics for Rheumatoid Arthritis
08/28 Broccoli Could Help Fight Arthritis ? WebMD
09/17 Rheumatoid arthritis and pregnancy: Advice, effects, and planning
06/14 Vagus nerve stimulation study shows significant reduction in rheumatoid arthritis symptoms: Initial pilot data support the use of new neurostimulation treatment in a larger study in patients who have failed current standard of care
01/08 Kambo: What to Know About Frog Medicine
04/25 European League Against Rheumatism (EULAR) 2005 Annual Meeting
11/28 Cure for rheumatoid arthritis? Scientists say they are close to breakthrough
06/09 5 Common Types of Arthritis
05/25 Children experience wrist and finger pain when using gaming devices and mobile phones over time
06/13 Study supports bisphosphonate use prior to denosumab to prevent loss of bone mineral density in post-menopausal women
10/08 How to Manage Depression Caused by RA
10/09 Rheumatoid Arthritis and the Flu: Why You Don't Want to Get It
08/14 Top Ways You Might Worsen Rheumatoid Arthritis Symptoms
10/22 What is a rheumatologist? Medical conditions, procedures, and more
03/21 For RA With COPD, Abatacept is Safe
11/23 Tiger Bone Wine
07/16 Five more Tetra Pak packages approved by the Swedish...
04/18 EULAR Releases Recommendations for Managing Behcet Syndrome
01/02 The risk of osteoarthritis and index to ring finger length ratio
10/31 ArtfixDaily Event Calendar
03/15 Blackstone Signs Definitive Agreement to Acquire AYUMI Pharmaceutical
04/04 EULAR Updates SLE Management Guidelines
06/13 Modified New York and ASAS Criteria Interchangeable in AxSpA With Radiographic Sacroiliitis
05/27 Fibromyalgia: Maligned, Misunderstood and (Finally) Treatable
11/14 Conservation How to forge rhinoceros horn
09/11 Undifferentiated Arthritis: Identifying Candidates for Early Treatment to Prevent Progression to RA
03/31 Ancient Egyptian Rheumatism And Gout Medicine, ‘Colchicine,’ Reduces Heart Inflammation
05/05 L-thyroxine does not improve subclinical hypothyroidism in those 65 or older
02/17 Coping with Rheumatism
03/14 Low-Dose Steroids Generally Safe in Rheumatic Diseases
06/12 63 Percent Of Rheumatoid Arthritis Patients Suffer Psychiatric Disorders, With Depressive Spectrum Conditions Most Likely
05/05 Angevine Middle School eighth grader named honoree in this year’s Walk to Cure Arthritis
05/11 Vaccination effective in spite of immune disease
05/11 A Critical Look at Race-based Practices in Rheumatology Guidelines
05/14 Foot Pain Common but Overlooked in RA
05/14 TRACES OF LAUREL: Lot Pitman descendants | Community
05/14 Crumbling mansion dubbed the 'Welsh Versailles' sells to mystery buyer for £950,000
03/27 Rheumatic Arthritis or Rheumatism: How to keep the disease from progressing; tips to keep your mobility intact
05/14 Health and Wellness Market Business Opportunity and Forecast 2021-2026 | Covid-19 Impact Analysis ? The Manomet Current
04/15 UMCG research: junk food, sugar and drink cause intestinal inflammation and thus diabetes and rheumatism (vegetarian food has the opposite effect)
05/10 Free of lockdown, tourists enjoy Turkey’s ‘white paradise’ Pamukkale | Daily Sabah
03/11 Roche rheumatism drug does not reduce Covid-19 deaths
05/12 DentaForce Reviews: Oral Care Ingredients That Work or...
02/12 What is the Difference Between Arthritis and Rheumatism?
11/05 Rheumatism drug could boost effectiveness of antibiotics against superbugs: study
07/17 Inflammatory rheumatism: Types, symptoms, and treatments
05/12 Contentious issues in gout management | OARRR
04/24 Controversy persists for palindromic rheumatism: RA precursor or distinct entity?
03/03 Combo Therapy Boosts Response in Uncontrolled Gout
06/17 EULAR: Early and intensive treatment of rheumatoid arthritis reduces fatigue
09/12 Palindromic rheumatism: What it is, symptoms, and outlook
04/23 Anti-rheumatism drug that also works on COVID-19
11/23 First flare of ACPA-positive rheumatoid arthritis after SARS-CoV-2 infection
06/08 Alpine Immune Sciences Provides Clinical Update of its Phase 1 Trial of ALPN-101 in Healthy Volunteers at the European League Against Rheumatism (EULAR) E-Congress 2020
06/05 EULAR 2020: Thrombosis risk particularly high for people suffering
03/25 COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study
03/30 Helping childhood-onset lupus patients stay healthy as adults
03/03 Cancer drugs shed light on rheumatism
06/09 EULAR advocates deployment of health care professionals -- study confirms effectiveness
07/07 Treatment with methotrexate and risk of lung disease in patients with rheumatoid arthritis
06/17 EULAR 2020: highlights from the European e-Congress of Rheumatology
06/18 Patients with rheumatic disease, COVID-19 more likely to require ventilation
03/16 Expert Advice on Coronavirus Risk in Immunocompromised Patients With Rheumatic Diseases
06/03 Study on COVID-19 and RMD provides reassurance to patients on immunosuppressive medication
11/18 Rheumatism Center / Krampe Schmidt Architects BDA
12/02 Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised, observer blinded clinical trial
06/03 New First-in-Class Phase 3 TREMFYA® (guselkumab) Data Demonstrate Improvement in Psoriatic Arthritis Joint and Skin Symptoms at Week 52
04/03 Palm trees can help cure headaches, rheumatism
04/01 The Prescription for Rheumatism Used to Be to Sit Inside a Rotting Whale for 30 Hours
06/08 Abbvie's Rinvoq matches BMS' Orencia in head-to-head rheumatoid arthritis trial
03/31 Australians bathed inside rotting whales to 'cure' rheumatism
04/20 Rheumatoid Arthritis and Working on the Job
05/15 Rituximab Effectively Treats ‘Forerunner’ of RA
07/23 In Alex Trebek’s reluctant, moving memoir, life is all about the next question
04/16 Rheumatic disease and COVID-19: initial data from the COVID-19 Global Rheumatology Alliance provider registries
07/30 8 hand exercises for arthritis: Pictures and the necessary equipment
10/24 AbbVie draws favorable rating for its rheumatism drug in Europe
08/04 Ankylosing spondylitis (AS): Becoming a mother despite having a rheumatic disease?
12/19 Arthritis, rheumatism and total joint arthroplasty: an interview with Dr Ravi and Dr Hawker
08/26 Rheumatoid Arthritis Diagnosis & Tests: How Doctors Diagnose RA
07/02 Can Copper or Magnetic Bracelets Ease Your Arthritis?
09/11 2019 EULAR/ACR Recommendations for SLE Classification Criteria
04/17 From the throat to the heart: Charting the long history of rheumatic fever
11/06 Rheumatoid Arthritis Complications and Effects on the Body
10/16 Are There Benefits to Drinking Kombucha?
11/07 Why an English Museum Has a Collection of Magic Potatoes
09/05 Pfizer Korea releases new tool for rheumatism injection
07/12 Mary K. Crow, MD, and Jane E. Salmon, MD, Named Honorary Members of the European League Against Rheumatism
10/30 'I Was Diagnosed With Rheumatoid Arthritis at 40-Right After I Had a Baby'
09/04 What is autoimmune arthritis? Symptoms and treatment
06/12 All men with gout should be routinely screened for erectile dysfunction
06/15 Gum disease may be a key initiator of rheumatoid arthritis related autoimmunity: Significantly higher prevalence of gum disease found in individuals at risk of rheumatoid arthritis compared to healthy controls
07/18 EULAR Updates Guidelines for Large Vessel Vasculitis
11/19 Start Treatment Early in RA, Even in Seronegatives
06/11 Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days
06/10 One third of rheumatoid arthritis patients experience sexual dysfunction
07/25 Did you know orchids can cure rheumatism?
03/30 Bizarre whale treatment for rheumatism revealed
03/16 Rheuminations: Blame the Pain on the Rain? | MedPage Today
06/17 Triple Therapy as Good as Biologics for Rheumatoid Arthritis
08/28 Broccoli Could Help Fight Arthritis ? WebMD
09/17 Rheumatoid arthritis and pregnancy: Advice, effects, and planning
06/14 Vagus nerve stimulation study shows significant reduction in rheumatoid arthritis symptoms: Initial pilot data support the use of new neurostimulation treatment in a larger study in patients who have failed current standard of care
01/08 Kambo: What to Know About Frog Medicine
04/25 European League Against Rheumatism (EULAR) 2005 Annual Meeting
11/28 Cure for rheumatoid arthritis? Scientists say they are close to breakthrough
06/09 5 Common Types of Arthritis
05/25 Children experience wrist and finger pain when using gaming devices and mobile phones over time
06/13 Study supports bisphosphonate use prior to denosumab to prevent loss of bone mineral density in post-menopausal women
10/08 How to Manage Depression Caused by RA
10/09 Rheumatoid Arthritis and the Flu: Why You Don't Want to Get It
08/14 Top Ways You Might Worsen Rheumatoid Arthritis Symptoms
10/22 What is a rheumatologist? Medical conditions, procedures, and more
03/21 For RA With COPD, Abatacept is Safe
11/23 Tiger Bone Wine
07/16 Five more Tetra Pak packages approved by the Swedish...
04/18 EULAR Releases Recommendations for Managing Behcet Syndrome
01/02 The risk of osteoarthritis and index to ring finger length ratio
10/31 ArtfixDaily Event Calendar
03/15 Blackstone Signs Definitive Agreement to Acquire AYUMI Pharmaceutical
04/04 EULAR Updates SLE Management Guidelines
06/13 Modified New York and ASAS Criteria Interchangeable in AxSpA With Radiographic Sacroiliitis
05/27 Fibromyalgia: Maligned, Misunderstood and (Finally) Treatable
11/14 Conservation How to forge rhinoceros horn
09/11 Undifferentiated Arthritis: Identifying Candidates for Early Treatment to Prevent Progression to RA
03/31 Ancient Egyptian Rheumatism And Gout Medicine, ‘Colchicine,’ Reduces Heart Inflammation
05/05 L-thyroxine does not improve subclinical hypothyroidism in those 65 or older
02/17 Coping with Rheumatism
03/14 Low-Dose Steroids Generally Safe in Rheumatic Diseases
06/12 63 Percent Of Rheumatoid Arthritis Patients Suffer Psychiatric Disorders, With Depressive Spectrum Conditions Most Likely
リウマチとは
リウマチとは
- 「リウマチ」、「リューマチ」、「リュウマチ」、「ロイマチ」とよばれます。
- 英語では、"Rheumatism", "Rheuma" と表記します。
- からだのあちこちの関節に炎症が起こり、関節が腫れて痛む病気です。
- 進行すると関節の変形や機能障害（使えなくなること）が起こります。
- おもに、下の２つが代表的な疾患とされます。
- 関節リウマチ と、
- リウマチ熱
日本全国でリウマチに悩む人は１００万人ともいわれ、その数は社会の高齢化にともない、年々増加しています。
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病院
関節リウマチ ( Rheumatoid Arthritis, RA )
関節リウマチ ( Rheumatoid Arthritis, RA )
関節リウマチ(Rheumatoid Arthritis：RA）は、自己の免疫が主に手足の関節を侵し、これにより関節痛、関節の変形が生じる代表的な膠原病の一つで、炎症性自己免疫疾患です。しばしば血管、心臓、肺、皮膚、筋肉といった全身臓器にも障害が及びます。
関節リウマチの原因
関節リウマチの原因
- 完全には病気の原因は究明されていません。
- 自己の免疫系（細菌などから体を防御するシステム）に異常があることが知られています。
- 免疫細胞が攻撃を始める根本原因は不明です。
- 遺伝的なもの（遺伝子が関係する）
- 感染した微生物（ウイルスや細菌）の影響
- 妊娠や出産など女性ホルモンの変化
関節リウマチの診断・早期診断(関節リウマチが疑われる症状)
リウマチの診断
多くの病院では、1987年米国リウマチ学会によって提唱された分類基準を参考にして、関節リウマチかどうかの診断します。（1994年に日本リウマチ学会が提唱した「早期関節リウマチの診断基準」を使う病院もあります。）
- 朝のこわばりが、少なくとも1時間以上にわたってみられる
- 3つ以上の関節に炎症による腫れがみられる
- 手首や手指のつけ根の関節、手指の第2関節に炎症による腫れがみられる
- 左右対称の関節に炎症による腫れがみられる
- 皮下結節（リウマトイド結節）がひじやひざなどにみられる
- 血液検査でリウマトイド因子が陽性である
- X線検査で手の関節に骨の萎縮などの変化がみられる
上記の7項目のうち、4項目以上にあてはまる場合を関節リウマチとする、とされています。
早期診断・リウマチが疑われる症状
早期のリウマチ患者では上記の基準に当てはまらないことも多くあります。以下は、リウマチを疑ったほうがよいとされる症状です。
- 関節の痛み、腫れがある
- 特に朝に、関節がこわばる
- 多くの関節に症状がある（3か所〜程度）
- 左右対称に症状がある（例：右手指と左手指）
関節リウマチの症状
関節リウマチの症状
- 関節炎
- 初期の症状「朝のこわばり(morning stiffness)」
朝起きてから、手をにぎることが困難であり、文字通りこわばります。
5-10分程度のこわばりは他の疾患でも診られますが、1時間以上も続くこわばりであれば関節リウマチまたは他のリウマチ性疾患の可能性が高い様です。
- そのうち、関節痛がおこるようになり、手指や足指の関節がおかされ、次第に手首、肘、膝など体の中心に近い大きな関節の痛みを感じるようになります。
- 関節痛は、手を動かすなど活動すると増強します。
- 関節炎が進行すると、関節そのものが変性し、最終的には関節が破壊し尽くされ、骨と骨が直接接した強直という状態になります。
- 手足の関節の他では、胸・腰の背骨はおかされないが首の背骨（頚椎）はおかされやすいようです。
- 頚部痛を生じたり、脊髄損傷、また、鎖骨に関節痛が起こる事もあります。
- 初期の症状「朝のこわばり(morning stiffness)」
- 血管
血管病変を合併する場合には、全身にくまなく留意しなければなりません。
心臓では狭心症・心筋梗塞、肺では肺高血圧症、腎臓では糸球体硬化症、脳では脳梗塞が起こりえます。
- 眼
関節リウマチ患者には、ドライアイもよく見られ、目の内側にリウマトイド結節が生じることもあります。
- 呼吸器
間質性肺炎、気道病変、胸膜病変、リウマチ結節、血管病変、睡眠時無呼吸症候群（顎関節病変、輪状披裂関節病変）などを合併することがあります。
- 心臓
心膜炎やリウマトイド結節を生じることもあります。
- 神経
関節リウマチに伴い血管炎が生ずれば、それに伴い多発単神経炎が起こる事があります。
- 皮膚
圧のかかる部位に、リウマチ結節と呼ばれる病変や、皮下出血などもみられることがあります。
- 血液
重症の関節リウマチ患者においては、脾腫、白血球（好中球のみ）減少をきたします。
関節リウマチの治療
関節リウマチの治療
現在の治療指針では関節リウマチの診断がついたら、出来るだけ早期に抗リウマチ薬(DMARDs), 生物学的製剤を用いることが推奨されています。痛みに対する対症療法として非ステロイド系消炎鎮痛剤（NSAIDs）などを用います。
- DMARDs（抗リウマチ薬）
関節リウマチの病気の勢いそのものを弱める薬として、メトトレキサート（リウマトレックス®）、スルファサラジン（アザルフィジン®）、 ブシラミン（リマチル®）、レフルノミド（アラバ®）、ミゾリビン、タクロリムス（プログラフ®）が使用されます。
欧米では抗マラリア薬であるヒドロキシクロロキンも使用され、免疫抑制薬であるアザチオプリン（イムラン®）、シクロスポリン（ネオーラル®）も効果が示されています。
- ステロイド
臨床試験の結果、ステロイドもDMARDsと同様に、病気の進行を遅らせる効果を示すことがわかり、DMARDsのみよりもDMARDsにステロイドを加えたほうが 病気の進行をさらに遅らせるという研究結果も報告されています。
- 抗サイトカイン療法
インフリキシマブ（レミケード®）、アダリムマブ(ヒュミラ®)、トシリズマブ(アクテムラ®)、エタネルセプト（エンブレル®）、アバタセプト(オレンシア®)は新しく開発されています。
これらはリウマチに対してきわめて強力な治療効果を示していますが、これらの薬剤は免疫応答に対する抑制効果が強く、しばしば感染症を引き起こすことがあり、 抗菌薬の併用などによる十分な予防を行う必要があります。
- その他の研究段階の新しい治療法
悪性リンパ腫に効果のあるリツキシマブ（リツキサン®）、抗生剤であるテトラサイクリン、高脂血症治療薬であるスタチン、多発性骨髄腫治療薬であるサリドマイドの効果や、 造血幹細胞移植の効果も検討されています。
- ビオチン治療法
各ビタミンの相互作用により、血中ビオチン値の上昇を目的とし、脾臓細胞における、免疫不全症の改善治癒を行うための治療方法です。
今までは、免疫不全症の原因が不明であることから、対処療法薬の投与をおこなう寛解維持療法がおこなわれていましたが、昨今の研究で、免疫不全症の一部の原因が初めて特定され、 これにより、ビオチン治療が確立しました。