Yuichi Maeda1,2, Toru Hirano3, Kosuke Ebina4, Ryota Hara5, Motomu Hashimoto6, Wataru Yamamoto7, Kosaku Murakami8, Takuya Kotani9, Kenichiro Hata9, Yonsu Son10, Hideki Amuro10, Akira Onishi11, Sadao Jinno11, Masaki Katayama12, Atsushi Kumanogoh3,13. 1. Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan. ymaeda@imed3.med.osaka-u.ac.jp. 2. Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan. ymaeda@imed3.med.osaka-u.ac.jp. 3. Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan. 4. Department of Musculoskeletal Regenerative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. 5. The Center for Rheumatic Diseases, Nara Medical University, Kashihara, Japan. 6. Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan. 7. Health Information Management, Kurashiki Sweet Hospital, Kurashiki, Japan. 8. Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan. 9. Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Japan. 10. First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan. 11. Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan. 12. Department of Rheumatology, Osaka Red Cross Hospital, Osaka, Japan. 13. Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan.
Abstract
OBJECTIVE: We aimed to investigate the efficacy of anti-IL-6 receptor antibody (aIL-6) and other biologic disease-modifying antirheumatic drugs (bDMARDs), such as TNF inhibitor and CTLA4-Ig in the treatment of rheumatoid arthritis (RA) in patients with knee joint involvement. METHODS: We retrospectively analyzed 1059 treatment courses of patients with RA who visited our hospitals and were treated with bDMARDs. We categorized them into two groups, with or without knee joint involvement. We investigated the clinical disease activity index (CDAI) at baseline and 12 weeks after the initiation of bDMARDs. We compared the improvement of the markers between aIL-6 and other bDMARDs. RESULTS: Treatment with aIL-6 significantly increased ΔCDAI (n = 91, 15.4 ± 1.1; mean ± SEM) in patients with knee joint involvement, compared to other bDMARDs (n = 232, 11.0 ± 0.7) at 12 weeks (P = 0.006). Following the multivariate analysis adjusted by the CDAI levels at baseline, age, gender, concomitant use of methotrexate, and the first use of bDMARDs, ΔCDAI levels were significantly higher in aIL-6, compared to other bDMARDs (P = 0.02). However, there was no significant difference in ΔCDAI improvement between aIL-6 (n = 162, 5.9 ± 0.6) and other bDMARDs (n = 573, 6.2 ± 0.4) in patients without swollen knee joints. ΔCDAI levels were equally increased in patients with shoulder and elbow joint involvement. CONCLUSION: aIL-6 was more effective in the patients with RA and knee joint involvement, compared to other bDMARDs.
OBJECTIVE: We aimed to investigate the efficacy of anti-IL-6 receptor antibody (aIL-6) and other biologic disease-modifying antirheumatic drugs (bDMARDs), such as TNF inhibitor and CTLA4-Ig in the treatment of rheumatoid arthritis (RA) in patients with knee joint involvement. METHODS: We retrospectively analyzed 1059 treatment courses of patients with RA who visited our hospitals and were treated with bDMARDs. We categorized them into two groups, with or without knee joint involvement. We investigated the clinical disease activity index (CDAI) at baseline and 12 weeks after the initiation of bDMARDs. We compared the improvement of the markers between aIL-6 and other bDMARDs. RESULTS: Treatment with aIL-6 significantly increased ΔCDAI (n = 91, 15.4 ± 1.1; mean ± SEM) in patients with knee joint involvement, compared to other bDMARDs (n = 232, 11.0 ± 0.7) at 12 weeks (P = 0.006). Following the multivariate analysis adjusted by the CDAI levels at baseline, age, gender, concomitant use of methotrexate, and the first use of bDMARDs, ΔCDAI levels were significantly higher in aIL-6, compared to other bDMARDs (P = 0.02). However, there was no significant difference in ΔCDAI improvement between aIL-6 (n = 162, 5.9 ± 0.6) and other bDMARDs (n = 573, 6.2 ± 0.4) in patients without swollen knee joints. ΔCDAI levels were equally increased in patients with shoulder and elbow joint involvement. CONCLUSION: aIL-6 was more effective in the patients with RA and knee joint involvement, compared to other bDMARDs.
Authors: Johannes W J Bijlsma; Paco M J Welsing; Thasia G Woodworth; Leonie M Middelink; Attila Pethö-Schramm; Corrado Bernasconi; Michelle E A Borm; Cornelis H Wortel; Evert Jan Ter Borg; Z Nazira Jahangier; Willemijn H van der Laan; George A W Bruyn; Paul Baudoin; Siska Wijngaarden; Petra A J M Vos; Reinhard Bos; Mirian J F Starmans; Eduard N Griep; Joanna R M Griep-Wentink; Cornelia F Allaart; Anton H M Heurkens; Xavier M Teitsma; Janneke Tekstra; Anne Carien A Marijnissen; Floris P J Lafeber; Johannes W G Jacobs Journal: Lancet Date: 2016-06-07 Impact factor: 79.321
Authors: Yukinori Okada; Di Wu; Gosia Trynka; Towfique Raj; Chikashi Terao; Katsunori Ikari; Yuta Kochi; Koichiro Ohmura; Akari Suzuki; Shinji Yoshida; Robert R Graham; Arun Manoharan; Ward Ortmann; Tushar Bhangale; Joshua C Denny; Robert J Carroll; Anne E Eyler; Jeffrey D Greenberg; Joel M Kremer; Dimitrios A Pappas; Lei Jiang; Jian Yin; Lingying Ye; Ding-Feng Su; Jian Yang; Gang Xie; Ed Keystone; Harm-Jan Westra; Tõnu Esko; Andres Metspalu; Xuezhong Zhou; Namrata Gupta; Daniel Mirel; Eli A Stahl; Dorothée Diogo; Jing Cui; Katherine Liao; Michael H Guo; Keiko Myouzen; Takahisa Kawaguchi; Marieke J H Coenen; Piet L C M van Riel; Mart A F J van de Laar; Henk-Jan Guchelaar; Tom W J Huizinga; Philippe Dieudé; Xavier Mariette; S Louis Bridges; Alexandra Zhernakova; Rene E M Toes; Paul P Tak; Corinne Miceli-Richard; So-Young Bang; Hye-Soon Lee; Javier Martin; Miguel A Gonzalez-Gay; Luis Rodriguez-Rodriguez; Solbritt Rantapää-Dahlqvist; Lisbeth Arlestig; Hyon K Choi; Yoichiro Kamatani; Pilar Galan; Mark Lathrop; Steve Eyre; John Bowes; Anne Barton; Niek de Vries; Larry W Moreland; Lindsey A Criswell; Elizabeth W Karlson; Atsuo Taniguchi; Ryo Yamada; Michiaki Kubo; Jun S Liu; Sang-Cheol Bae; Jane Worthington; Leonid Padyukov; Lars Klareskog; Peter K Gregersen; Soumya Raychaudhuri; Barbara E Stranger; Philip L De Jager; Lude Franke; Peter M Visscher; Matthew A Brown; Hisashi Yamanaka; Tsuneyo Mimori; Atsushi Takahashi; Huji Xu; Timothy W Behrens; Katherine A Siminovitch; Shigeki Momohara; Fumihiko Matsuda; Kazuhiko Yamamoto; Robert M Plenge Journal: Nature Date: 2013-12-25 Impact factor: 49.962