Clémentine Fortunet1, Yves-Marie Pers2, Joseph Lambert2, Marie Godfrin-Valnet2, Elodie Constant2, Hervé Devilliers2, Philippe Gaudin2, Christian Jorgensen2, Béatrice Pallot Prades2, Daniel Wendling2, Jean Francis Maillefert3. 1. Department of Rheumatology, Dijon University Hospital, INSERM U1093, UFR Médecine, University of Burgundy, Dijon, Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, Montpellier, Department of Rheumatology, Grenoble University Hospital, Grenoble, Department of Rheumatology, Besançon University Hospital, Besançon, Department of Rheumatology, Saint Etienne University Hospital, Saint Etienne and Department of Internal Medicine and Systemic Disease Unit, Dijon University Hospital, Dijon, France. Department of Rheumatology, Dijon University Hospital, INSERM U1093, UFR Médecine, University of Burgundy, Dijon, Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, Montpellier, Department of Rheumatology, Grenoble University Hospital, Grenoble, Department of Rheumatology, Besançon University Hospital, Besançon, Department of Rheumatology, Saint Etienne University Hospital, Saint Etienne and Department of Internal Medicine and Systemic Disease Unit, Dijon University Hospital, Dijon, France. clementinefortunet@gmail.com. 2. Department of Rheumatology, Dijon University Hospital, INSERM U1093, UFR Médecine, University of Burgundy, Dijon, Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, Montpellier, Department of Rheumatology, Grenoble University Hospital, Grenoble, Department of Rheumatology, Besançon University Hospital, Besançon, Department of Rheumatology, Saint Etienne University Hospital, Saint Etienne and Department of Internal Medicine and Systemic Disease Unit, Dijon University Hospital, Dijon, France. 3. Department of Rheumatology, Dijon University Hospital, INSERM U1093, UFR Médecine, University of Burgundy, Dijon, Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, Montpellier, Department of Rheumatology, Grenoble University Hospital, Grenoble, Department of Rheumatology, Besançon University Hospital, Besançon, Department of Rheumatology, Saint Etienne University Hospital, Saint Etienne and Department of Internal Medicine and Systemic Disease Unit, Dijon University Hospital, Dijon, France. Department of Rheumatology, Dijon University Hospital, INSERM U1093, UFR Médecine, University of Burgundy, Dijon, Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, Montpellier, Department of Rheumatology, Grenoble University Hospital, Grenoble, Department of Rheumatology, Besançon University Hospital, Besançon, Department of Rheumatology, Saint Etienne University Hospital, Saint Etienne and Department of Internal Medicine and Systemic Disease Unit, Dijon University Hospital, Dijon, France.
Abstract
OBJECTIVE: . The aim of this study was to evaluate the impact of introducing tocilizumab (TCZ) as co-therapy with CS in patients with RA. METHODS: This study was an open, observational, retrospective multicentre study. RA patients treated with oral CS for >3 months who started treatment with TCZ between December 2009 and June 2011 in five centres were included. Variables included demographic data, disease history, co-treatments, disease activity and dose of CS at inclusion and at weeks 4, 8, 12 and 24. The evolution of disease activity and of the dose of CS (analysis of variance with repeated measures) were analysed, searching for factors correlated with changes in the dose of CS. RESULTS: Inclusion of 130 patients [women 80.8%, mean age 56.7 years (s.d. 14.0), RA duration 16.3 years (s.d. 10.4), mean baseline 28-joint DAS (DAS28) 5.1 (s.d. 1.4), mean baseline dose of CS 10.0 mg/day (s.d. 8.2) prednisone equivalent. Decreases in the mean daily dose of CS and in the DAS28 were observed during follow-up [respectively 6.5 mg (s.d. 4.8) at week 24 (P < 0.0001) and 3.0 mg (s.d. 1.4) at week 24 (P < 0.0001)]. The only variable that correlated with the decrease in the dose of CS was the initial dose of the drug (r = 0.82, P < 0.001). CONCLUSION: The introduction of TCZ led to rapid and long-lasting CS sparing that did not correlate with the reduction in disease activity. It is possible that in patients treated with high-dose CS, the main objective of the clinician is to reduce dosage of CS rather than RA activity.
OBJECTIVE: . The aim of this study was to evaluate the impact of introducing tocilizumab (TCZ) as co-therapy with CS in patients with RA. METHODS: This study was an open, observational, retrospective multicentre study. RA patients treated with oral CS for >3 months who started treatment with TCZ between December 2009 and June 2011 in five centres were included. Variables included demographic data, disease history, co-treatments, disease activity and dose of CS at inclusion and at weeks 4, 8, 12 and 24. The evolution of disease activity and of the dose of CS (analysis of variance with repeated measures) were analysed, searching for factors correlated with changes in the dose of CS. RESULTS: Inclusion of 130 patients [women 80.8%, mean age 56.7 years (s.d. 14.0), RA duration 16.3 years (s.d. 10.4), mean baseline 28-joint DAS (DAS28) 5.1 (s.d. 1.4), mean baseline dose of CS 10.0 mg/day (s.d. 8.2) prednisone equivalent. Decreases in the mean daily dose of CS and in the DAS28 were observed during follow-up [respectively 6.5 mg (s.d. 4.8) at week 24 (P < 0.0001) and 3.0 mg (s.d. 1.4) at week 24 (P < 0.0001)]. The only variable that correlated with the decrease in the dose of CS was the initial dose of the drug (r = 0.82, P < 0.001). CONCLUSION: The introduction of TCZ led to rapid and long-lasting CS sparing that did not correlate with the reduction in disease activity. It is possible that in patients treated with high-dose CS, the main objective of the clinician is to reduce dosage of CS rather than RA activity.
Authors: F Iannone; G Ferraccioli; L Sinigaglia; E G Favalli; P Sarzi-Puttini; F Atzeni; R Gorla; C Bazzani; M Govoni; I Farina; E Gremese; A Carletto; A Giollo; M Galeazzi; R Foti; L Bianchino; L La Grasta; G Lapadula Journal: Clin Rheumatol Date: 2017-10-05 Impact factor: 2.980
Authors: Lisa Baganz; Adrian Richter; Jörn Kekow; Arnold Bussmann; Andreas Krause; Carsten Stille; Joachim Listing; Angela Zink; Anja Strangfeld Journal: Rheumatol Int Date: 2017-11-16 Impact factor: 2.631
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Authors: Matthijs S van der Leeuw; Paco M J Welsing; Maria J H de Hair; Johannes W G Jacobs; Anne C A Marijnissen; Suzanne P Linn-Rasker; Faouzia Fodili; Reinhard Bos; Janneke Tekstra; Jacob M van Laar Journal: Trials Date: 2020-04-05 Impact factor: 2.279