Modern Rheumatology

, Volume 21, Issue 4, pp 370–374

In rheumatoid arthritis patients treated with tocilizumab, the rate of clinical disease activity index (CDAI) remission at 24 weeks is superior in those with higher titers of IgM-rheumatoid factor at baseline

  • Shin-ya Kawashiri
  • Atsushi Kawakami
  • Naoki Iwamoto
  • Keita Fujikawa
  • Toshiyuki Aramaki
  • Mami Tamai
  • Satoshi Yamasaki
  • Hideki Nakamura
  • Tomoki Origuchi
  • Yukitaka Ueki
  • Kiyoshi Migita
  • Akinari Mizokami
  • Kiyoshi Aoyagi
  • Katsumi Eguchi
Original Article

DOI: 10.1007/s10165-010-0409-0

Cite this article as:
Kawashiri, S., Kawakami, A., Iwamoto, N. et al. Mod Rheumatol (2011) 21: 370. doi:10.1007/s10165-010-0409-0

Abstract

We aimed to evaluate the efficacy of tocilizumab in patients with rheumatoid arthritis (RA), using the clinical disease activity index (CDAI), and to determine the baseline variables associated with CDAI remission. Fifty-eight patients with active RA were enrolled. We tried to evaluate whether baseline variables were associated with CDAI remission at 24 weeks. Twenty-two of the 58 patients (37.9%) had received tumor necrosis factor (TNF) inhibitors. The continuation rate of tocilizumab at 24 weeks was 87.9%. The seropositivity rates of IgM-rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies at baseline were both 91.4%. The rate of CDAI remission at 24 weeks was 20.7%. We selected baseline variables including age, gender, duration of disease, concomitant use of glucocorticoids, concomitant use of methotrexate (MTX), previous anti-TNF therapy, titer of anti-CCP antibodies (high or low toward median), titer of IgM-RF (high or low toward median), and CDAI, and found that a high titer of IgM-RF was the only variable to be associated with CDAI remission, according to univariate and logistic regression analyses. This is a new finding, and may be specific to tocilizumab as compared with previous observations in anti-TNF therapy.

Keywords

TocilizumabRheumatoid arthritisCDAIIgM-RF

Abbreviations

ACR

American College of Rheumatology

CDAI

Clinical disease activity index

CRP

C-reactive protein

DAS

Disease activity score

DMARDs

Disease-modifying antirheumatic drugs

ESR

Erythrocyte sedimentation rate

IL-6

Interleukin-6

MMP-3

Matrix metalloproteinase

RA

Rheumatoid arthritis

TJC

Tender joint count

TNF

Tumor necrosis factor

SJC

Swollen joint count

VAS

Visual analogue scale

Copyright information

© Japan College of Rheumatology 2011

Authors and Affiliations

  • Shin-ya Kawashiri
    • 1
  • Atsushi Kawakami
    • 1
  • Naoki Iwamoto
    • 1
  • Keita Fujikawa
    • 1
  • Toshiyuki Aramaki
    • 1
  • Mami Tamai
    • 1
  • Satoshi Yamasaki
    • 1
  • Hideki Nakamura
    • 1
  • Tomoki Origuchi
    • 2
  • Yukitaka Ueki
    • 3
  • Kiyoshi Migita
    • 4
  • Akinari Mizokami
    • 5
  • Kiyoshi Aoyagi
    • 6
  • Katsumi Eguchi
    • 1
  1. 1.Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical SciencesNagasaki UniversityNagasakiJapan
  2. 2.Nagasaki University School of Health SciencesNagasaki UniversityNagasakiJapan
  3. 3.Center for Rheumatic DiseaseSasebo Chuo HospitalSaseboJapan
  4. 4.Department of General Internal MedicineNHO National Nagasaki Medical CenterNagasakiJapan
  5. 5.Department of Internal MedicineNagasaki Municipal HospitalNagasakiJapan
  6. 6.Department of Public HealthNagasaki University Graduate School of Biomedical SciencesNagasakiJapan