title: Evaluation of switching from intravenous to subcutaneous formulation of tocilizumab in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To evaluate the efficacy of switching the route from intravenous tocilizumab (TCZ) infusion (TCZ-IV) to subcutaneous TCZ injection (TCZ-SC) in a real-world setting through a comparison of the clinical response.
  
  
  METHODS
  Fifty-eight rheumatoid arthritis (RA) patients, for whom TCZ-SC was initiated following TCZ-IV between June 2013 and August 2014, were consecutively enrolled. Disease activity score (DAS)28-ESR, simplified disease activity index (SDAI), and clinical disease activity index (CDAI) were examined at baseline and after switching from TCZ-IV to TCZ-SC for 3 months. We investigated whether body weight and body mass index (BMI) affected the efficacy of TCZ-SC.
  
  
  RESULTS
  Most of the patients had achieved remission or low disease activity at baseline (77.6% examined by DAS28). Fifty-seven patients (98%) continued the TCZ-SC treatment, and the disease activity was well controlled after 3 months. ΔDAS28 tended to be worsened after switching to TCZ-SC in the high-body-weight groups (≥60 kg) as compared with the groups with body weight <60 kg, although no statistical significance was found. BMI did not affect the efficacy of TCZ-SC.
  
  
  CONCLUSIONS
  Caution should be exercised in the high-body-weight subjects, but these data indicate that TCZ-SC maintains the favorable RA disease activity established using TCZ-IV.
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Naoki
authors.initials: N
authors.lastname: Iwamoto
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Shoichi
authors.initials: S
authors.lastname: Fukui
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Masataka
authors.initials: M
authors.lastname: Umeda
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Ayako
authors.initials: A
authors.lastname: Nishino
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Nakashima
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Takahisa
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Horai
authors.affiliation: b Department of Internal Medicine , Sasebo City General Hospital , Sasebo , Japan .
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Nonaka
authors.affiliation: c Department of Rheumatology , The Japanese Red Cross Nagasaki Genbaku Hospital , Nagasaki , Japan .
authors.forename: Akitomo
authors.initials: A
authors.lastname: Okada
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Koga
authors.affiliation: d Department of Public health , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Shin-Ya
authors.initials: SY
authors.lastname: Kawashiri
authors.affiliation: e Department of Rheumatology , Japan Community Health Care Organization, Isahaya General Hospital , Isahaya , Japan .
authors.forename: Keita
authors.initials: K
authors.lastname: Fujikawa
authors.affiliation: f Department of Rheumatology , Sasebo Chuo Hospital , Sasebo , Japan , and.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Aramaki
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Ichinose
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Hirai
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Mami
authors.initials: M
authors.lastname: Tamai
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: f Department of Rheumatology , Sasebo Chuo Hospital , Sasebo , Japan , and.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Terada
authors.affiliation: c Department of Rheumatology , The Japanese Red Cross Nagasaki Genbaku Hospital , Nagasaki , Japan .
authors.forename: Munetoshi
authors.initials: M
authors.lastname: Nakashima
authors.affiliation: e Department of Rheumatology , Japan Community Health Care Organization, Isahaya General Hospital , Isahaya , Japan .
authors.forename: Akinari
authors.initials: A
authors.lastname: Mizokami
authors.affiliation: g Department of Health Science , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Origuchi
authors.affiliation: b Department of Internal Medicine , Sasebo City General Hospital , Sasebo , Japan .
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
authors.affiliation: f Department of Rheumatology , Sasebo Chuo Hospital , Sasebo , Japan , and.
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Ueki
authors.affiliation: a Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan .
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; C502936:tocilizumab
keywords: Rheumatoid arthritis; Subcutaneous injection; Tocilizumab