title: Clinical results for tocilizumab over one year in the clinical setting as assessed by CDAI (clinical disease activity index): CRP at week 12 and MMP-3 at week 24 are predictive factors for CDAI.
abstract: To investigate the clinical results of 1 year tocilizumab (TCZ) treatment of rheumatoid arthritis patients in clinical practice by using the clinical disease activity index (CDAI). Thirty-one patients with inadequate response to DMARDs, including methotrexate (MTX), or TNF inhibitors received TCZ (8 mg every 4 weeks). The clinical responses were measured using the 28-joint disease activity score (DAS28-ESR) and CDAI. Matrix metalloproteinase-3 (MMP-3) was assessed as a serological biomarker. Mean baseline DAS28-ESR was 5.96, decreasing to 2.89 at week 52 with a remission rate (DAS28-ESR < 2.6) of 35.5%. Mean baseline CDAI was 28.4, decreasing to 10.2 at week 52 with a remission rate (CDAI ≤ 2.8) of 22.6%. Of patients whose CRP levels had fallen to below the limit of detection by week 12, 65.2% achieved remission or low disease activity as assessed by CDAI at week 52. Median baseline MMP-3 level was 165.7 ng/mL, decreasing to 79.5 ng/mL at week 52. A positive correlation was seen between CDAI at week 52 and MMP-3 level from week 12 onward. About 50% of the patients treated with TCZ in clinical practice achieved a low disease activity level at week 52 as assessed by CDAI, which does not include acute-phase proteins. Our results suggested that CRP levels falling to below the limit of detection by week 12 and MMP-3 ≤ 80.6 ng/mL at week 24 could predict low disease activity or remission at week 52 as assessed by CDAI.
authors: Department of Orthopedic Surgery and Rheumatology, Nagoya Medical Center, National Hospital Organization, 4-1-1 Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001 Nagoya, Japan. a-kaneko@xj.commufa.jp
authors: Atsushi
authors: A
authors: Kaneko
authors: Daihei
authors: D
authors: Kida
authors: Kiwamu
authors: K
authors: Saito
authors: Masami
authors: M
authors: Tsukamoto
authors: Tomotaro
authors: T
authors: Sato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000097:blood; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D012074:Remission Induction / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D015415:Biomarkers; D019278:Matrix Metalloproteinase 3; C502936:tocilizumab; D008727:Methotrexate