Vol.22 No.3

Original Article

Early aggressive intervention with tocilizumab for rheumatoid arthritis increases remission rate defined using a Boolean approach in clinical practice

Authors

Toshihisa Kojima1 , Atsushi Kaneko2 , Yuji Hirano3 , Hisato Ishikawa4 , Hiroyuki Miyake5 , Hideki Takagi6 , Yuichiro Yabe7 , Takefumi Kato8 , Kenya Terabe9 , Naoki Fukaya10 , Hiroki Tsuchiya6 , Tomone Shioura11, Koji Funahashi1, Masatoshi Hayashi1, Daizo Kato1, Hiroyuki Matsubara1, Naoki Ishiguro1,12

  • Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University, School of Medicine, 65 Tsurumai, Showa, Nagoya, Japan
  • Department of Orthopedic Surgery, Nagoya Medical Center, Nagoya, Japan
  • Department of Rheumatology, Toyohashi Municipal Hospital, Toyohashi, Japan
  • Department of Rheumatology, Nagano Red Cross Hospital, Nagano, Japan
  • Department of Orthopedic Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan
  • Department of Orthopedic Surgery, Nagoya Kyoritsu Hospital, Nagoya, Japan
  • Department of Rheumatology, Tokyo Kosei Nenkin Hospital, Tokyo, Japan
  • Kato Orthopedic Clinic, Okazaki, Japan
  • Department of Orthopedic Surgery, Fukuroi Municipal Hospital, Fukuroi, Japan
  • Department of Orthopedic Surgery, Kariya-Toyota General Hospital, Kariya, Japan
  • Department of Orthopedic Surgery, Shizuoka Kosei Hospital, Shizuoka, Japan
  • Department of Orthopedic Surgery, Faculty and Graduate School of Medicine, Nagoya University, Nagoya, Japan
Received:

10 May 2011

Accepted:

23 August 2011

Published online:

20 September 2011

Full Text

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Abstract

The goal of treating rheumatoid arthritis (RA) should be remission, for which a new definition was proposed in 2011. To determine which patients can achieve the new Boolean-based definition of remission in clinical practice, we analyzed factors associated with remission in 123 patients who received tocilizumab for 52 weeks. We found that patients with short disease duration (<4.8 years) had a significantly higher rate of remission (31.7%) than those with longer disease duration, and patient global assessment was the most important factor for achieving remission. Multivariate analysis revealed the following predictors of remission: short disease duration [<4.8 years; odds ratio (OR) 2.5, 95% confidence interval (CI) 1.4-4.7] and lower disease activity [28-joint disease activity score- erythrocyte sedimentation rate (DAS28-ESR) <5.23; OR 2.5, 95% CI 1.2-5.1). In this study, we showed that remission, as newly defined using a Boolean approach, is a realistic goal for patients treated with tocilizumab with short disease duration in real-world clinical practice.

Key words

Rheumatoid arthritis - Remission - Tocilizumab - Patient-reported outcome - Interleukin 6