Ching-Tsai Lin1, Wen-Nan Huang2, Chia-Wei Hsieh1, Yi-Ming Chen2, Der-Yuan Chen3, Tsu-Yi Hsieh1, Yi-Hsing Chen4. 1. Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan. 2. Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. 3. Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Biomedical Science and Ron Hsing Research Center for Translational Medicine, National Chung-Hsing University, Taichung, Taiwan. 4. Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: ysanne@vghtc.gov.tw.
Abstract
OBJECTIVE: To evaluate the long-term safety and effectiveness of tocilizumab (TCZ) for the treatment of rheumatoid arthritis (RA) in a real-world clinical setting in Taiwan. METHOD: All refractory RA patients who initiated intravenous TCZ between August 2012 and March 2015 were enrolled. Data on patient characteristics, drug safety and effectiveness were collected. RESULTS: A total of 114 RA patients were recruited. Despite the majority of them (93%) had previous biologic failure, 43.75% of the patients were able to reach ACR50 after one year. Serious adverse events commonly found were bacterial pneumonia (4.24/100 patient-years) followed by cellulitis (2.12/100 patient-years). Twenty-three patients had old or latent TB infections, 11 patients had chronic hepatitis B. During the 3 years follow-up, none of them had reactivation of TB, or hepatitis B with concomitant use of isoniazid prophylaxis or pre-emptive antiviral treatment. CONCLUSION: In this 3-year real-world study on RA patients of Taiwan, we found a good long-term effectiveness and similar safety profiles for the TCZ treatment. With prophylactic strategy for latent TB and pre-emptive antiviral treatment for HBV carriers, the risk of reactivation of latent TB and HBV may be reassured.
OBJECTIVE: To evaluate the long-term safety and effectiveness of tocilizumab (TCZ) for the treatment of rheumatoid arthritis (RA) in a real-world clinical setting in Taiwan. METHOD: All refractory RApatients who initiated intravenous TCZ between August 2012 and March 2015 were enrolled. Data on patient characteristics, drug safety and effectiveness were collected. RESULTS: A total of 114 RApatients were recruited. Despite the majority of them (93%) had previous biologic failure, 43.75% of the patients were able to reach ACR50 after one year. Serious adverse events commonly found were bacterial pneumonia (4.24/100 patient-years) followed by cellulitis (2.12/100 patient-years). Twenty-three patients had old or latent TB infections, 11 patients had chronic hepatitis B. During the 3 years follow-up, none of them had reactivation of TB, or hepatitis B with concomitant use of isoniazid prophylaxis or pre-emptive antiviral treatment. CONCLUSION: In this 3-year real-world study on RApatients of Taiwan, we found a good long-term effectiveness and similar safety profiles for the TCZ treatment. With prophylactic strategy for latent TB and pre-emptive antiviral treatment for HBV carriers, the risk of reactivation of latent TB and HBV may be reassured.
Authors: Tianxi Cai; Yichi Zhang; Yuk-Lam Ho; Nicholas Link; Jiehuan Sun; Jie Huang; Tianrun A Cai; Scott Damrauer; Yuri Ahuja; Jacqueline Honerlaw; Jie Huang; Lauren Costa; Petra Schubert; Chuan Hong; David Gagnon; Yan V Sun; J Michael Gaziano; Peter Wilson; Kelly Cho; Philip Tsao; Christopher J O'Donnell; Katherine P Liao Journal: JAMA Cardiol Date: 2018-09-01 Impact factor: 14.676
Authors: Sung Soo Ahn; Seung Min Jung; Jason Jungsik Song; Yong Beom Park; Jun Yong Park; Sang Won Lee Journal: Yonsei Med J Date: 2018-05 Impact factor: 2.759