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SAT0126 Rate of Remission by Tocilizumab or Methotrexate Induction Therapy in Early Active Rheumatoid Arthritis: Results of the Tomera Trial.
  1. P. Durez1,
  2. G. Depresseux1,
  3. A. Nzeusseu Toukap1,
  4. B. Lauwerys1,
  5. L. Meric de Bellefon1,
  6. M. Stoenoiu1,
  7. F. A. Houssiau1
  1. 1Rheumatology, Service et Pôle de Rhumatologie, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium


Background Tocilizumab (TCZ), as monotherapy and in combination with methotrexate (MTX), has been shown to be efficacious in RA patients with insufficient response to MTX. Similar beneficial effects of TCZ were observed in early rheumatoid arthritis (ERA) and in RA patients refractory to TNF inhibitors. We aimed to compare the remission rates in ERA patients treated with TCZ or MTX.

Methods Eligible patients had a disease duration ≤2 years, were MTX-naive, and had active RA (DAS28 ≥3.2). Thirty (23 women and 7 men) ERA patients were randomized to receive either TCZ 8 mg/kg every month or MTX 20 mg weekly, for 6 months in both groups. After 24 weeks, all patients were treated with MTX up to 20 mg weekly. At baseline, patients’ characteristics did not differ between groups (mean age +/- SD {56.9 +/- 10.4}vs{49.4 +/- 14.0}, mean disease duration {0.49 +/- 1.3}vs {0.99 +/- 2.3}, mean DAS 28-CRP {4.7 +/- 1.3} vs {4.4 +/- 1.0}, mean HAQ {1.4 +/- 0.7} vs {0.9 +/- 0.6}, for the TCZ and MTX group, respectively).

ACR and EULAR core set values and remission criteria were evaluated monthly. Statistical differences were analyzed using unpaired Mann-Whitney Rank and Fisher exact tests.

Results 13 and 17 ERA patients were included in the MTX and TCZ arm, respectively. Percentage of patients achieving DAS28-CRP<2.6, SDAI<3.3, no SJC, ACR-EULAR Boolean-defined remission and HAQ<0.5 are shown in the Table.

Conclusions These results indicate that remission at 6 month is more common with TCZ compared to MTX in ERA patients. The benefit is however lost at 18 months, when TCZ is withdrawn and the effect of MTX catches up.

Acknowledgements TCZ prescribed in this study was kindly provided by Roche, Belgium.

Disclosure of Interest None Declared

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