Vol.21 No.4

Original Article

In rheumatoid arthritis patients treated with tocilizumab, the rate of clinical disease activity index (CDAI) remission at 24 weeks is superior in those with higher titers of IgM-rheumatoid factor at baseline

Authors

Shin-ya Kawashiri1 , Atsushi Kawakami1 , Naoki Iwamoto1 , Keita Fujikawa1 , Toshiyuki Aramaki1 , Mami Tamai1 , Satoshi Yamasaki1 , Hideki Nakamura1 , Tomoki Origuchi2 , Yukitaka Ueki3 , Kiyoshi Migita4 , Akinari Mizokami5, Kiyoshi Aoyagi6, Katsumi Eguchi1

  • Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
  • Nagasaki University School of Health Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan
  • Center for Rheumatic Disease, Sasebo Chuo Hospital, Sasebo, Japan
  • Department of General Internal Medicine, NHO National Nagasaki Medical Center, Nagasaki, Japan
  • Department of Internal Medicine, Nagasaki Municipal Hospital, Nagasaki, Japan
  • Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
Received:

30 July 2010

Accepted:

14 December 2010

Published online:

15 January 2011

Full Text

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Abstract

We aimed to evaluate the efficacy of tocilizumab in patients with rheumatoid arthritis (RA), using the clinical disease activity index (CDAI), and to determine the baseline variables associated with CDAI remission. Fifty-eight patients with active RA were enrolled. We tried to evaluate whether baseline variables were associated with CDAI remission at 24 weeks. Twenty-two of the 58 patients (37.9%) had received tumor necrosis factor (TNF) inhibitors. The continuation rate of tocilizumab at 24 weeks was 87.9%. The seropositivity rates of IgM-rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies at baseline were both 91.4%. The rate of CDAI remission at 24 weeks was 20.7%. We selected baseline variables including age, gender, duration of disease, concomitant use of glucocorticoids, concomitant use of methotrexate (MTX), previous anti-TNF therapy, titer of anti-CCP antibodies (high or low toward median), titer of IgM-RF (high or low toward median), and CDAI, and found that a high titer of IgM-RF was the only variable to be associated with CDAI remission, according to univariate and logistic regression analyses. This is a new finding, and may be specific to tocilizumab as compared with previous observations in anti-TNF therapy.

Key words

Tocilizumab - Rheumatoid arthritis - CDAI - IgM-RF