Aktif Romatoid Artrit Hastalarında Klinik Pratikte Tocilizumab'ın İki Yıllık Etkinliği

Reumatol Clin. 2016; May 10 doi: 10.1016/j.reuma.2016.03.014 [Epub ahead of print]

The efficacy and safety of tocilizumab has been studied in several randomized clinical trials (RCTs) but due to the strict inclusion and exclusion criteria of RCTs, real-life observational studies are needed to supplement the findings from these trials. This small longitudinal, open-label study from an outpatient clinic in Spain evaluated the effectiveness, survival rate and reasons for treatment discontinuations in 85 patients treated with tocilizumab over a 24-month period. The study also assessed the impact of three clinical variables: seropositivity status, monotherapy versus DMARD-combination therapy and treatment history (biologic-treatment naïve vs. biologic- inadequate responders), on therapeutic response and survival.As expected, tocilizumab was associated with improvements in disease activity. The results also showed that neither the use of concomitant DMARD therapy nor baseline seropositivity status had an impact on clinical response. However, a higher treatment response was observed in patients who did not receive prior biologic treatment compared with those who werebiologic-inadequate responders.At 12 months, the survival rate was 72%. Lack of efficacy, and safety were the main reasons for treatment discontinuation. There was no difference in survival rates between patients who received tocilizumab as a monotherapy versus combination therapy, nor were these affected by patient seropositivity status or treatment history.