title: Clinical, radiographic and functional effectiveness of tocilizumab for rheumatoid arthritis patients--REACTION 52-week study.
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of tocilizumab in RA patients in clinical practice.
  
  
  METHODS
  We observed 232 consecutive RA patients who began tocilizumab in three rheumatology centres in Japan for 52 weeks. Clinical, radiographic and functional status and safety were evaluated.
  
  
  RESULTS
  Mean age of the 232 patients was 59.1 years, mean duration of disease was 12.4 years and average DAS using the 28-joint count (DAS-28) was 5.6. Although 62.8% of the patients had been treated previously with anti-TNF biologics, clinical remission at Week 52 was achieved in 43.7%, radiographic non-progression in 62.8% and functional remission in 26.4%. Retention rate at Week 52 was 71.1%, and the same for those with or without previous anti-TNF treatment. Adverse drug reactions leading to tocilizumab discontinuation were observed in 15.5% of patients, the most frequent adverse drug reaction being pneumonia in eight cases. On multivariate logistic regression analysis, DAS-28, HAQ-disability index (HAQ-DI), concomitant MTX and concomitant glucocorticoids (GCs) were predictive variables for clinical remission at Week 52 of tocilizumab treatment. In particular, HAQ-DI was found to be a predictive variable for remission of all three types-clinical, radiographic and functional-at Week 52 of tocilizumab treatment.
  
  
  CONCLUSIONS
  In daily clinical practice, tocilizumab exhibited excellent effectiveness in established RA patients, some of whom had failed to respond to previous anti-TNF treatment. Although further detailed safety findings are required, this study provides valuable real-world findings on the management of RA with tocilizumab.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. tsutake@z5.keio.jp
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Koichi
authors.initials: K
authors.lastname: Amano
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hoshi
authors.forename: Masao
authors.initials: M
authors.lastname: Nawata
authors.forename: Hayato
authors.initials: H
authors.lastname: Nagasawa
authors.forename: Eri
authors.initials: E
authors.lastname: Sato
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Saito
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Fukuyo
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kurasawa
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hanami
authors.forename: Hideto
authors.initials: H
authors.lastname: Kameda
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D001175:Arthrography; D004185:Disability Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006304:Health Status; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D020127:Recovery of Function; D012074:Remission Induction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D005938:Glucocorticoids; C502936:tocilizumab; D008727:Methotrexate