Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Multiple Regression Analysis on the Clinical Parameters Associating with Clinical, Structural and Functional Remission at 52 Weeks in RA Patients Treated with Anti-IL-6 Receptor Antibody, Tocilizumab REACTION-2 Study.

Takeuchi2,  Tsutomu, Tanaka5,  Yoshiya, Amano1,  Kouichi, Sato4,  Eri, Nawata5,  Masao, Nagasawa1,  Hayato, Hoshi4,  Daisuke

Division of Rheumatology and Clinical Immunology, Department of Internal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan
Division of Rheumatology, School of Medicine, Keio University, Tokyo, Japan
Division of Rheumatology, School of Medicine, Keio University, Tokyo, Japan
Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan

Purpose:

In order to identify the baseline clinical parameters associating with remission in RA patients treated with anti-IL-6 receptor monoclonal, tocilizumab (TCZ), we attempt to analyze clinical, laboratory and radiographic date set of REACTION-2 study by multiple logistic regression analysis.

Patients and Methods:

In REACTION-2 study, a total of 255 RA patients were treated with TCZ 8 mg/kg every four weeks in three major rheumatic centers as daily clinical practice. In the assessment of disease activity, DAS28-ESR score <2.6 was defined as clinical remission, and non-responder imputation was used for missing data. For joint damage, modified TSS <=0.5 was defined as structural remission, and for functional disability, HAQ score <=0.5 was defined as functional remission. The associations with each type of remission were analyzed by multiple logistic regression analysis. The last-observation-carried-forward method was used in each of the analyses.

Results:

Baseline characteristics of 255 patients showed that the mean age was 59.1 ± 13.3 years, the mean duration of RA was 12.4 ± 11.1 years, Methotrexate was used by 55.6% of patients, with the mean dose 5.31 ± 4.8 mg/week, and the mean steroid dose was 3.9 mg/day. Although a large proportion of patients, 62.8%, had been previously treated with biologics, the mean DAS28-ESR was 5.72.

Logistic regression analysis of baseline clinical parameters and clinical remission at 52 weeks demonstrated that clinical remission was significantly associated with younger age, lower DAS28-ESR, lower HAQ score, higher MTX dose and lower steroid dose at baseline. Multiple regression analysis of these associations confirmed that all the above factors independently influenced the achievement of clinical remission.

Similarly, multiple regression analysis revealed that HAQ score at baseline independently influenced the achievement of structural remission, while logistic regression analysis identified two significant parameters such as HAQ score and steroid dose at baseline.

Finally, multiple regression analysis demonstrated that only HAQ score at baseline independently influenced the achievement of functional remission, while logistic regression analysis showed six significant parameters including age, duration of RA, DAS28-ESR, HAQ score, mTSS score and MTX dose at baseline.

Conclusions:

In this analysis, we identified the baseline clinical parameters influencing the various types of remission at 52 weeks by treatment with TCZ in clinical practice. It appears that baseline HAQ score before TCZ treatment is an important factor that influences clinical, structural and functional remission.

To cite this abstract, please use the following information:
Takeuchi, Tsutomu, Tanaka, Yoshiya, Amano, Kouichi, Sato, Eri, Nawata, Masao, Nagasawa, Hayato, et al; Multiple Regression Analysis on the Clinical Parameters Associating with Clinical, Structural and Functional Remission at 52 Weeks in RA Patients Treated with Anti-IL-6 Receptor Antibody, Tocilizumab REACTION-2 Study. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1823
DOI: 10.1002/art.29588

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