Abstract | OBJECTIVE: METHODS: The SURPRISE study was a 2-year, open-label randomised controlled study. Among patients who had been randomised to additional tocilizumab (ADD-ON) or switch to tocilizumab (SWITCH) in the first year, those who achieved remission based on the disease activity score for 28 joints (DAS28-ESR<2.6) discontinued tocilizumab at week 52 and were observed for the following 52 weeks. The endpoint of the second year included tocilizumab-free remission and low disease-activity rates, functional outcome, radiological outcomes assessed with the modified total Sharp score (mTSS) and safety. The efficacy of reinstituted tocilizumab/ methotrexate was also evaluated. RESULTS: A total of 105 patients who achieved remission at week 52 discontinued tocilizumab; 51 in ADD-ON continued methotrexate and 54 in SWITCH received no disease-modifying antirheumatic drugs. Sustained DAS28 low disease-activity rates were significantly higher in ADD-ON than in SWITCH (55%vs27%, p=0.005). Sustained remission rates at week 104 were 24% for ADD-ON and 14% for SWITCH (p=0.29). Radiological progression was comparable between both groups (mTSS; 0.37vs0.64, p=0.36). The restart of tocilizumab induced remission in all except two patients after 36 weeks, irrespective of concomitant methotrexate. CONCLUSION: TRIAL REGISTRATION NUMBER: NCT01120366; Results.
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Authors | Yuko Kaneko, Masaru Kato, Yoshiya Tanaka, Masayuki Inoo, Hitomi Kobayashi-Haraoka, Koichi Amano, Masayuki Miyata, Yohko Murakawa, Hidekara Yasuoka, Shintaro Hirata, Eiichi Tanaka, Nobuyuki Miyasaka, Hisashi Yamanaka, Kazuhiko Yamamoto, Tsutomu Takeuchi, SURPRISE study group |
Journal | Annals of the rheumatic diseases
(Ann Rheum Dis)
Vol. 77
Issue 9
Pg. 1268-1275
(09 2018)
ISSN: 1468-2060 [Electronic] England |
PMID | 29853455
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. |
Chemical References |
- Antibodies, Monoclonal, Humanized
- Antirheumatic Agents
- tocilizumab
- Methotrexate
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Topics |
- Adult
- Aged
- Antibodies, Monoclonal, Humanized
(adverse effects, therapeutic use)
- Antirheumatic Agents
(adverse effects, therapeutic use)
- Arthritis, Rheumatoid
(drug therapy)
- Drug Substitution
- Drug Therapy, Combination
- Female
- Humans
- Male
- Methotrexate
(adverse effects, therapeutic use)
- Middle Aged
- Prospective Studies
- Remission Induction
- Severity of Illness Index
- Treatment Outcome
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