Method: Baseline characterisitics, efficacy as measured by disease activity score using the 28 joint count (DAS)28-ESR, clinical disease activity index (CDAI), health assessment questionnaire-disability index (HAQ-DI), and modified total Sharp score (mTSS) were assessed.
Result: In total, 145 patients with inadequate response to the anti-TNF therapies were analyzed. At baseline, mean age was 56.6±14.6 years (median [min-max]: 61.0 [15-88]), mean duration of disease was 12.4±10.5 years (median [min-max]: 10.0 [0.1-56.2]), methotrexate (MTX) was concomitantly used in 64.1%. The mean DAS28-ESR, CDAI and HAQ score was improved from 5.71±1.25 at baseline to 2.84±1.53 (% of <2.6=48.5) at week 52, from 26.7±13.1 to, 9.84±9.12 (% of ≤2.8=22.4), and 1.54±0.74 to 1.19±0.81 (% of ≤0.5=26.9), respectively..Analysis of 95 patients with available mTSS revealed the estimated yearly progression (ΔTSS) at baseline to be 16.7, but this had improved to 1.1 at 52 weeks, indicating 93.4% inhibition of joint destruction. Structural remission (ΔTSS≤0.5) was achieved in 53 patients (55.8%). The incidence of the patients who reached DAS28-ESR<2.6, CDAI≤2.8, and ΔTSS≤0.5 were improved significantly after switching from anti-TNF agents to tocilizumab (Table). Especially, Estimated ΔTSS after TCZ treatment (1.37) was significant improved from the EYP during one year anti-TNF treatment.
|Mean DAS28-ESR (% of <2.6)||5.24 (0%)||5.85 (0%)||2.87 (50%)|
|Mean CDAI (% of ≤2.8)||21.1 (0%)||27.4 (0%)||11.1 (18.9%)|
|Mean HAQ (% of ≤0.5)||1.24 (16.2%)||1.46 (7.9%)||1.12 (15.8%)|
|ΔTSS (% of ≤0.5)||3.55 (42.1%)||1.37 (63.2%)|
Conclusion: The clinical response and the efficacy in prevention of joint damage were significantly improved compared to pretreatment by switchin to tocilizumab from TNF-inhibitors in RA patients with inadequate response to TNF-inhibitors.
Disclosure: Y. Tanaka, Abbott, Astellas Pharma, Chugai Pharma, Mitsubishi-Tanabe Pharma, MSD, Pfizer, Takeda Pharma, 2, Abbott, Astellas Pharma, Chugai Pharma, Eisai Pharma, Mitsubishi-Tanabe Pharma, 8 ; T. Takeuchi, Abbott, Bristol-Myers Squibb, Chugai Pharma, Eisai Pharma, Mitsubishi-Tanabe Pharma, Takeda Pharma, Janssen Pharma, Pfizer, 2 ; K. Amano, Abbott, Astellas Pharma, Chugai Pharma, Eisai Pharma, Mitsubishi-Tanabe Pharma, 2 ; E. Sato, None; M. Nawata, None; H. Nagasawa, None; D. Hoshi, None; K. Saito, None; S. Fukuyo, None; K. Hanami, None; H. Kameda, Mitsubishi-Tanabe Pharma, Centocor, Pfizer, Takeda Pharma, Abbott, Eisai Pharma, Chugai Pharma, 2 ; T. Kurasawa, None; Y. Kaneko, None; H. Yamanaka, Abbott, Bristol-Myers Squibb, Chugai Pharma, Eisai Pharma, Hoffmann-La Roche, Mitsubishi-Tanabe Pharma, Takeda Pharma, Pfizer, 2 .