Current treatments of rheumatoid arthritis: from the ‘NinJa’ registry

Abstract

In this review, recent changes in both treatments and outcomes of rheumatoid arthritis (RA) in Japan were analyzed by viewing the National Database of Rheumatic Diseases by iR-net, one of the largest clinical databases for RA patients in Japan. Regarding drug therapy, the use of methotrexate has been continuously increasing and has established a place as an anchor drug in the treatment of RA among other nonbiologic disease-modifying antirheumatic drugs; however, the dosage used is still significantly less compared with that of western countries. In addition to methotrexate, the use of tacrolimus has increased gradually. The most prominent observed change is a rapid increase in the use of biologics, which rose to stardom in the treatment of RA in Japan and western countries. These changes in drug therapy could allow us to control RA disease activity more tightly. In line with this, the outcomes of patients with RA in Japan have been improving continuously, both clinically and functionally. Subsequently, the use of both NSAIDs and corticosteroids has decreased. In addition, overall rates of joint operations related to RA have also decreased; in particular, a significant decrease was noticed in the incidence of joint replacement and synovectomy. Overall, the trends in treatments and subsequent outcomes for RA in Japan have exactly followed those seen in western countries.

Keywords::

• clinical database
• Japan
• NinJa
• outcomes
• rheumatoid arthritis
• treatments

Acknowledgements

The authors thank all of the patients registered in the National Database of Rheumatic Diseases by iR-net in Japan and members of the iR-net Study Group.

Financial & competing interests disclosure

This work was supported by both the grants of the Ministry of Health, Labour and Welfare of the Japanese Government and those of the National Hospital Organization. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

Data of the registered patients are accumulated every year.

CRP: C-reactive protein; DMARD: Disease-modifying antirheumatic drug; ESR: Erythrocyte sedimentation rate; mHAQ: Modified health assessment questionnaire; VAS: Visual analog scale.