title: Early aggressive intervention with tocilizumab for rheumatoid arthritis increases remission rate defined using a Boolean approach in clinical practice.
abstract: The goal of treating rheumatoid arthritis (RA) should be remission, for which a new definition was proposed in 2011. To determine which patients can achieve the new Boolean-based definition of remission in clinical practice, we analyzed factors associated with remission in 123 patients who received tocilizumab for 52 weeks. We found that patients with short disease duration (<4.8 years) had a significantly higher rate of remission (31.7%) than those with longer disease duration, and patient global assessment was the most important factor for achieving remission. Multivariate analysis revealed the following predictors of remission: short disease duration [<4.8 years; odds ratio (OR) 2.5, 95% confidence interval (CI) 1.4-4.7] and lower disease activity [28-joint disease activity score-erythrocyte sedimentation rate (DAS28-ESR) <5.23; OR 2.5, 95% CI 1.2-5.1). In this study, we showed that remission, as newly defined using a Boolean approach, is a realistic goal for patients treated with tocilizumab with short disease duration in real-world clinical practice.
authors.affiliation: Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya University, School of Medicine, 65 Tsurumai, Showa, Nagoya, Japan. toshik@med.nagoya-u.ac.jp
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Kojima
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kaneko
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hirano
authors.forename: Hisato
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Miyake
authors.forename: Hideki
authors.initials: H
authors.lastname: Takagi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yabe
authors.forename: Takefumi
authors.initials: T
authors.lastname: Kato
authors.forename: Kenya
authors.initials: K
authors.lastname: Terabe
authors.forename: Naoki
authors.initials: N
authors.lastname: Fukaya
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tsuchiya
authors.forename: Tomone
authors.initials: T
authors.lastname: Shioura
authors.forename: Koji
authors.initials: K
authors.lastname: Funahashi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hayashi
authors.forename: Daizo
authors.initials: D
authors.lastname: Kato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsubara
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019947:Receptors, Interleukin-6 / Q000037:antagonists & inhibitors; D012042:Registries; D012074:Remission Induction; D055502:Secondary Prevention; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D019947:Receptors, Interleukin-6; C502936:tocilizumab