1208 - Risk of Infections In Rheumatoid Arthritis Patients Treated with Tocilizumab – a Retrospective Data-Analysis

Monday, November 7, 2011: 9:00 AM-6:00 PM
Hall F2 - Poster Hall (McCormick Place West)
Veronika Lang1, Matthias Englbrecht1, Jürgen Rech1, Bernhard Manger2, Georg Schett3 and Jochen Zwerina4, 1University of Erlangen-Nuremberg, Erlangen, Germany, 2Medical School Erlangen, Erlangen, Germany, 3Department of Internal Medicine 3 and Institute for Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany, 4University of Erlangen-Nuremberg, Germany, Erlangen, Germany
Presentation Number: 1208

Background/Purpose: The human anti- interleukin 6 receptor (IL-6R) antibody tocilizumab is approved for the treatment of rheumatoid arthritis (RA) in patients who inadequately respond or are intolerant to therapy with DMARDs or TNF-alpha inhibitors. Infections are the most common adverse event during tocilizumab therapy. Therefore, we investigated the occurrence and risk factors for infections in rheumatoid arthritis (RA) patients treated with tocilizumab in clinical practice.

Method: A cohort of all RA patients (N = 112) receiving tocilizumab therapy between October 2008 and March 2010 in Northern Bavaria, Germany, was assessed for the incidence of infections. Mild/moderate and severe infections were recorded. Multivariate logistic regression analysis was used to analyze risk factors for infection.

Results: In total, 26 patients developed infections (23.2%, 58.0/100py), 18 of them experienced mild to moderate infections (16.1%, 40.1/100py) and 8 faced severe infections (7.1%, 17.9/100py). One patient died. Concomitant use of leflunomide and prednisone, high disease activity and previous therapy with rituximab were associated with the occurrence of mild/moderate infections. Severe infections were related to age, longer disease duration, exposure to more than 3 previous DMARDs and concomitant therapy with proton pump inhibitors (PPI).

Conclusion: The rate of infection in RA patients treated with tocilizumab in clinical practice is higher compared with the populations in clinical trials. Increased awareness should especially be given to patients with higher age and longer disease duration, those concomitantly using leflunomide, prednisone or PPI as well as those with a previous exposure to rituximab.

Keywords: infection, rheumatoid arthritis (RA) and tocilizumab

Disclosure: V. Lang, None; M. Englbrecht, None; J. Rech, None; B. Manger, None; G. Schett, None; J. Zwerina, None.