title: Incidence of paradoxical reactions in patients treated with tocilizumab for rheumatoid arthritis: Data from the French registry REGATE.
abstract: Assess the frequency of paradoxical reactions encountered in daily practice under tocilizumab, using the REGATE (Registry-RoActemra) registry. The secondary objectives were to determine the type of paradoxical reaction and the consequences of these reactions.
  
  
  
  The REGATE registry is an independent prospective registry, promoted by the French Society of Rheumatology, consisting of patients treated with tocilizumab for rheumatoid arthritis. The paradoxical reaction was retained if it was a paradoxical precipitation of a condition for which tocilizumab was indicated, if tocilizumab was being used for an alternative indication, and if it appeared after at least one tocilizumab infusion.
  
  
  
  Among the 1491 patients included with at least one follow-up visit (3429 patient-years), a paradoxical reaction occurred in 9 patients (0.60% of patients; 2.62/1000 patient-years). These were 7 de novo pathologies (3 vasculitis, 3 uveitis, 1 lupus) and 2 exacerbations of pre-existing conditions (1 vasculitis, 1 lupus). Permanent discontinuation of tocilizumab was chosen for 5 patients.
  
  
  
  In the REGATE registry, the occurrence of paradoxical reactions in patients treated with tocilizumab was rare.
authors.affiliation: Rheumatology department, CHU de Reims, 51092 Reims cedex, France. Electronic address: wterreaux@gmail.com.
authors.forename: William
authors.initials: W
authors.lastname: Terreaux
authors.affiliation: Department of Research and Public Health, CHU de Reims, 51000 Reims, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Masson
authors.affiliation: Rheumatology department, CHU de Reims, 51092 Reims cedex, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Eschard
authors.affiliation: Rheumatology department, CHU Lariboisière, 75010 Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bardin
authors.affiliation: Rheumatology department, CHU de Toulouse, 31000 Toulouse, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Constantin
authors.affiliation: Rheumatology department, centre hospitalier de Lievin, 62800 Liévin, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Le Dantec
authors.affiliation: Rheumatology department, CHU de Caen, 14003 Caen, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Marcelli
authors.affiliation: Rheumatology department, CHU de Rennes, 35000 Rennes, France.
authors.forename: Aleth
authors.initials: A
authors.lastname: Perdriger
authors.affiliation: Rheumatology department, centre hospitalier de Perpignan, 66046 Perpignan, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Scotto Di Fazano
authors.affiliation: Rheumatology department, CHU de Besançon, 34294 Montpellier, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.affiliation: Rheumatology department, CHU de Strasbourg, 34294 Montpellier, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
authors.affiliation: Rheumatology department, CHU de Montpellier, 34294 Montpellier, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Morel
authors.affiliation: Rheumatology department, CHU de Reims, 51092 Reims cedex, France.
authors.forename: Jean-Hugues
authors.initials: JH
authors.lastname: Salmon
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D013997:Time Factors
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C502936:tocilizumab
keywords: Lupus; Paradoxical reactions; Rheumatoid arthritis; Tocilizumab; Uveitis; Vasculitis