Background There are few data about Tocilizumab (TCZ) in monotherapy effectiveness in clinical practice conditions
Objectives To analyze the effectiveness TCZ monotherapy at medium/long term in clinical practice
Methods Observational, retrospective, multicenter, 2-year study of RA patients on TCZ monotherapy.We recorded: demographic and clinical data (duration of RA, RF and CCP antibodies, previous treatments and reason for its discontinuation); At baseline and at 3, 6, 9, 12, 18 and 24 months:RA activity (DAS-28 ESR index, TJC, SJC, ESR, CRP and % of patients in Remission or Low Disease Activity (LDA). Adverse effects were also recorded
Results 123 patients were included, with a mean age of 57.7±12.5 years and 85.4% females. Mean disease duration of 14.4±12.0 y; 67.5% and 59'3% were RF and anti-CCP positive. 98.4% had previously received conventional DMARD (2 DMARDs: 30.9% and ≥3 DMARDs: 38.2%), reasons for DMARD discontinuation were inefficacy (26%), adverse events (58.5), patient decision (8.9%) and other reasons (4.1%). 13% had not received prior biological DMARDs; 34.1% had received 1; 20.3% 2; 16.3% 3; 8.9% 4 and 6.5% ≥5)
A relationship between Remission/LDA and disease duration and reason for discontinuation of prior conventional DMARD was not found. An association among the number of previous biological treatments and a low disease activity at 6 m (p<0.017), 9m (p<0.025) and 12m (p<0.028) was observed. 41 patients discontinued treatment (33.3%): 17due to inefficacy, 13 due to AE, 4 because of patient decision and 7 due to other reasons. No association between discontinuation of TCZ and duration of disease or number of previous biological DMARDs was found.
Conclusions In our experience, TCZ monotherapy is effective at medium/long term regardless of the duration of the disease and previous treatments, maintaining a high retention rate
Disclosure of Interest None declared
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