Efficacy and safety of tocilizumab in refractory rheumatoid arthritis: a real life cohort from a single centre.

Abstract

OBJECTIVES:

Tocilizumab (TCZ) is an effective treatment in patients with rheumatoid arthritis (RA) refractory to anti-tumour necrosis factor-α. However, only few studies in real life have evaluated the efficacy of TCZ in long-standing rheumatoid arthritis (LSRA). Our aim was to evaluate the efficacy and safety of tocilizumab in refractory LSRA.

METHODS:

Twenty-seven consecutive patients with refractory LSRA treated with at least one biologic agent were enrolled in a 19-month study in a single centre. Demographic [age, gender, disease duration, body mass index (BMI), previous therapies], clinical [total swollen and tender joints count (SJC-TJC) on 28, 44 and 68 joints, DAS28, Health Assessment Questionnaire (HAQ), infections, cardiovascular, renal, pulmonary and metabolic comorbidities], and serological [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies] data were collected. Patients were evaluated at baseline, and after three and six months.

RESULTS:

Mean disease duration was 16.75±9.94 years. Seventeen out of 27 (62.9%) were RF positive and 13/27 (48.1%) were CCP positive. All of them experienced at least one previous biological agent (mean value 1.9±1.15; range 1-6). We observed a progressive reduction in all clinical and clinimetric features evaluated as well as a progressive reduction in steroids use. The EULAR response also improved. By analysing the RF positive subgroup we found that there is a better clinical response both at the 3rd and 6th month.

CONCLUSIONS:

TCZ is an effective and safe treatment in refractory LSRA.

• Authors: Olga Addimanda, Niccolò Possemato, Pierluigi Macchioni, Carlo Salvarani
• Journal: Clinical and experimental rheumatology (Clin Exp Rheumatol) 2014 Jul-Aug Vol. 32 Issue 4 Pg. 460-4 ISSN: 0392-856X [Print] Italy
• PMID: 24960220 (Publication Type: Journal Article, Observational Study)

Chemical References

• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents
• Biological Products
• Biomarkers
• Steroids
• tocilizumab

Topics

• Adult
• Aged
• Antibodies, Monoclonal, Humanized (adverse effects, therapeutic use)
• Antirheumatic Agents (adverse effects, therapeutic use)
• Arthritis, Rheumatoid (blood, diagnosis, drug therapy)
• Biological Products (adverse effects, therapeutic use)
• Biomarkers (blood)
• Drug Substitution
• Drug Therapy, Combination
• Female
• Humans
• Italy
• Male
• Middle Aged
• Predictive Value of Tests
• Severity of Illness Index
• Steroids (adverse effects, therapeutic use)
• Time Factors
• Treatment Outcome