Objectives To explore the radiographic efficacy of tocilizumab (TCZ) in rheumatoid arthritis (RA) patients with or without the prior use of anti-tumor necrosis factor (TNF) agents in daily clinical practice.
Methods Of a total of consecutive 115 RA patients initiating TCZ treatment in Keio university hospital from July 2008 to March 2011, 46 patients who had x-rays of the both hands and feet were assessed stratified by the use of prior biologics (BIO+) and no use of them (BIO-). They received 8 mg/kg of TCZ every 4 weeks, and were observed for 52 weeks to evaluate the clinical and structural outcomes.
Results Baseline patient characteristics (BIO+, BIO-) were as follows: mean age of 54.8±11.2 years, 52.5±12.5 years; mean disease duration of RA of 6.8±6.5 years, 4.0±3.4 years; concomitant use of methotrexate in 76.9%, 48.5% and use of concomitant glucocorticoid was in 46.2%, 36.4%. Baseline patients’ characteristics were comparable between BIO+ and BIO- groups except for ESR (65.9±32.3 in BIO+ vs 42.4±35.3 in BIO-). In BIO+ and BIO- patients, DAS28 remission (DAS28-ESR < 2.6) was achieved in 61.5% and 81.8%, SDAI remission in 38.5% and 54.5%, CDAI remission 38.5% and 51.5%, respectively. Radiographic remission (Δmodified Total Sharp Score ≦0.5) was 46.2% (6/13) in BIO+ patients and 66.7% (22/33) in BIO- patients. There were no significant differences in clinical and structural remission rates between the two groups.
Conclusions The treatment with TCZ improved RA patients clinically and structurally regardless of the prior use of anti-TNF biologicsin daily clinical practice.
Disclosure of Interest None Declared