Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.


Impact of Tocilizumab Therapy After Switching From Tumor Necrosis Factor (TNF) inhibitors Prevention of Joint Damage by Tocilizumab in Patients with Inadequate Response to Anti-TNF Therapies.

Tanaka1,  Yoshiya, Takeuchi2,  Tsutomu, Amano3,  Koichi, Sato4,  Eri, Nawata5,  Masao, Nagasawa6,  Hayato, Hoshi7,  Daisuke

University of Occupational and Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
Keio University School of Medicine, Tokyo, Japan
Saitama Medical Center, Saitama Medical University, Saitama, Japan
Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
Saitama Medical Ctr, Kawagoe, Japan
Tokyo Women's Medical University, Tokyo, Japan
University of Occupational & Environmental Health, Japan, Kitakyushu, Japan
Keio Univ School of Medicine, Shinjuku-ku, Japan

Background/Purpose:

Anti-TNF agents are highly effective, but clinical remission is achieved in only about 40% of patients. In this study, we evaluated the efficacy of tocilizumab (TCZ) for preventing the joint damage as well as clinical and functional improvement in patients with inadequate response to anti-TNF agents by comparing the efficacy achieved during anti-TNF therapy one year prior to TCZ treatment.

Methods:

Baseline characterisitics, efficacy as measured by disease activity score using the 28 joint count (DAS)28-ESR, clinical disease activity index (CDAI), health assessment questionnaire-disability index (HAQ-DI), and modified total Sharp score (mTSS) were assessed.

Results:

In total, 145 patients with inadequate response to the anti-TNF therapies were analyzed. At baseline, mean age was 56.6±14.6 years (median [min-max]: 61.0 [15–88]), mean duration of disease was 12.4±10.5 years (median [min-max]: 10.0 [0.1–56.2]), methotrexate (MTX) was concomitantly used in 64.1%. The mean DAS28-ESR, CDAI and HAQ score was improved from 5.71±1.25 at baseline to 2.84±1.53 (% of <2.6=48.5) at week 52, from 26.7±13.1 to, 9.84±9.12 (% of <=2.8=22.4), and 1.54±0.74 to 1.19±0.81 (% of <=0.5=26.9), respectively..Analysis of 95 patients with available mTSS revealed the estimated yearly progression (DTSS) at baseline to be 16.7, but this had improved to 1.1 at 52 weeks, indicating 93.4% inhibition of joint destruction. Structural remission (DTSS<=0.5) was achieved in 53 patients (55.8%). The incidence of the patients who reached DAS28-ESR<2.6, CDAI<=2.8, and DTSS<=0.5 were improved significantly after switching from anti-TNF agents to tocilizumab (Table). Especially, Estimated DTSS after TCZ treatment (1.37) was significant improved from the EYP during one year anti-TNF treatment.

 -52w0w52w
Mean DAS28-ESR (% of <2.6)5.24 (0%)5.85 (0%)2.87 (50%)
Mean CDAI (% of <=2.8)21.1 (0%)27.4 (0%)11.1 (18.9%)
Mean HAQ (% of <=0.5)1.24 (16.2%)1.46 (7.9%)1.12 (15.8%)
DTSS (% of <=0.5)3.55 (42.1%)1.37 (63.2%) 
    

Conclusion:

The clinical response and the efficacy in prevention of joint damage were significantly improved compared to pretreatment by switchin to tocilizumab from TNF-inhibitors in RA patients with inadequate response to TNF-inhibitors.

To cite this abstract, please use the following information:
Tanaka, Yoshiya, Takeuchi, Tsutomu, Amano, Koichi, Sato, Eri, Nawata, Masao, Nagasawa, Hayato, et al; Impact of Tocilizumab Therapy After Switching From Tumor Necrosis Factor (TNF) inhibitors Prevention of Joint Damage by Tocilizumab in Patients with Inadequate Response to Anti-TNF Therapies. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1239
DOI:

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