{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:06:24Z","timestamp":1792710384812,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,5,25]],"date-time":"2018-05-25T00:00:00Z","timestamp":1527206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["16ek0109060h0103"],"award-info":[{"award-number":["16ek0109060h0103"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2018,7]]},"abstract":"Objective<\/jats:title>To evaluate the effectiveness of tumor necrosis factor (TNF<\/jats:styled-content>) inhibitors for the treatment of human T lymphotropic virus type I (HTLV<\/jats:styled-content>\u2010I)\u2013positive patients with rheumatoid arthritis (RA<\/jats:styled-content>) in an area endemic for HTLV<\/jats:styled-content>\u2010I infection.<\/jats:p><\/jats:sec>Methods<\/jats:title>We conducted an observational study of 585 RA<\/jats:styled-content> patients in whom TNF<\/jats:styled-content> inhibitors were newly introduced as a first biologic disease\u2010modifying antirheumatic drug in an area in southwestern Japan that is endemic for HTLV<\/jats:styled-content>\u2010I infection.<\/jats:p><\/jats:sec>Results<\/jats:title>Fifty patients (8.5%) were anti\u2013HTLV<\/jats:styled-content>\u2010I antibody\u2013positive. The ages of the patients in this group were significantly higher at entry compared with the ages of patients who were anti\u2013HTLV<\/jats:styled-content>\u2010I antibody\u2013negative (n = 535). The median Disease Activity Score in 28 joints using the erythrocyte sedimentation rate (DAS<\/jats:styled-content>28\u2010ESR<\/jats:styled-content>) was 5.21. Among the total group of patients, 82% were anti\u2013citrullinated protein antibody (ACPA<\/jats:styled-content>)\u2013positive. The persistence rate of TNF<\/jats:styled-content> inhibitors at 24 weeks was 89%. The median DAS<\/jats:styled-content>28\u2010ESR<\/jats:styled-content> was significantly decreased at 24 weeks in each group. The European League Against Rheumatism (EULAR<\/jats:styled-content>) response rate was significantly better in the anti\u2013HTLV<\/jats:styled-content>\u2010I antibody\u2013negative patients (P<\/jats:italic> = 0.0277). Multiple regression analysis demonstrated that anti\u2013HTLV<\/jats:styled-content>\u2010I antibody status was significantly associated with the EULAR<\/jats:styled-content> response rate and change in the DAS<\/jats:styled-content>28\u2010ESR<\/jats:styled-content> and was prominent especially in the ACPA<\/jats:styled-content>\u2010negative subjects. No patients developed adult T cell leukemia\/lymphoma (ATL<\/jats:styled-content>) or HTLV<\/jats:styled-content>\u2010I\u2013associated myelopathy (HAM<\/jats:styled-content>) during the 24\u2010week treatment period.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The efficacy of TNF<\/jats:styled-content> inhibitors may be attenuated in anti\u2013HTLV<\/jats:styled-content>\u2010I antibody\u2013positive patients with RA<\/jats:styled-content>. ATL<\/jats:styled-content> and HAM<\/jats:styled-content> did not develop when TNF<\/jats:styled-content> inhibitors were used for 24 weeks, but the long\u2010term risk is not known.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40461","type":"journal-article","created":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T01:09:31Z","timestamp":1519348171000},"page":"1014-1021","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Brief Report: Attenuated Effectiveness of Tumor Necrosis Factor Inhibitors for Anti\u2013Human T Lymphotropic Virus Type I Antibody\u2013Positive Rheumatoid Arthritis"],"prefix":"10.1002","volume":"70","author":[{"given":"Takahisa","family":"Suzuki","sequence":"first","affiliation":[{"name":"Japanese Red Cross Nagasaki Genbaku Hospital Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichi","family":"Fukui","sequence":"additional","affiliation":[{"name":"Nagasaki 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