Vol.23 No.6

Original Article

Shorter disease duration is important for tocilizumab to achieve Boolean remission

Authors

Yoshiko Kawasaki1 , Teppei Hashimoto1 , Takaichi Okano1 , Yoshitada Sakai1, 4 , Takashi Yamane2 , Kazuko Shiozawa2 , Shunichi Shiozawa1, 3 , Akira Hashiramoto1

  • The Center for Rheumatic Diseases, Kobe University Hospital, Kobe 650-0017, Japan
  • Rheumatic Diseases Center, Konan Kakogawa Hospital, Kakogawa 675-8545, Japan
  • Department of Medicine, Kyushu University Beppu Hospital, Oita 874-0838, Japan
  • Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
Received:

21 August 2012

Accepted:

14 December 2012

Published online:

5 February 2013

Full Text

PDF　(member's only)

Abstract

Objective To determine the optimal conditions for inducing rheumatoid arthritis (RA) into disease remission by tocilizumab (TCZ), we analyzed the TCZ therapy carried out in our facility.
Method The study group comprised 116 patients with RA who started TCZ therapy at Kobe University Hospital and Konan-Kakogawa Hospital. The clinical response to TCZ was evaluated by the 2011 Boolean definition and the disease activity score of 28 joints erythrocyte sedimentation rate 4 (DAS28-ESR4).
Results After 24 weeks of TCZ therapy, 25.9 % of the patients achieved a Boolean-defined disease remission (Boolean remission). DAS28-ESR4 was improved from 5.25 ± 1.15 at week 0 to 2.75 ± 1.34 at week 24 (mean ± SD, P%ABST%.0001), and 57.8 % patients achieved DAS28 remission. Analysis of the relationship between disease duration and remission showed that this odds ratio peaked at 3.0 years. Univariate analyses showed that Boolean remission was associated with baseline ESR levels, Steinbrocker’s class and stage, and patient global assessment of disease activity (PGA). Accordingly, we categorized and compared the patient groups referring to the 3.0-year peak. We found significant differences in Steinbrocker’s class and stage.
Conclusion TCZ therapy leading to Boolean disease remission is optimal when initiated less than 3.0 years after disease onset.

Key words

Remission, Rheumatoid arthritis, Tocilizumab