Original Article

Modern Rheumatology

, Volume 22, Issue 3, pp 370-375

Early aggressive intervention with tocilizumab for rheumatoid arthritis increases remission rate defined using a Boolean approach in clinical practice

  • Toshihisa KojimaAffiliated withDepartment of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University, School of Medicine Email author 
  • , Atsushi KanekoAffiliated withDepartment of Orthopedic Surgery, Nagoya Medical Center
  • , Yuji HiranoAffiliated withDepartment of Rheumatology, Toyohashi Municipal Hospital
  • , Hisato IshikawaAffiliated withDepartment of Rheumatology, Nagano Red Cross Hospital
  • , Hiroyuki MiyakeAffiliated withDepartment of Orthopedic Surgery, Ichinomiya Municipal Hospital
  • , Hideki TakagiAffiliated withDepartment of Orthopedic Surgery, Nagoya Kyoritsu Hospital
  • , Yuichiro YabeAffiliated withDepartment of Rheumatology, Tokyo Kosei Nenkin Hospital
  • , Takefumi KatoAffiliated withKato Orthopedic Clinic
  • , Kenya TerabeAffiliated withDepartment of Orthopedic Surgery, Fukuroi Municipal Hospital
    • , Naoki FukayaAffiliated withDepartment of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University, School of MedicineDepartment of Orthopedic Surgery, Kariya-Toyota General Hospital
    • , Hiroki TsuchiyaAffiliated withDepartment of Orthopedic Surgery, Nagoya Kyoritsu Hospital
    • , Tomone ShiouraAffiliated withDepartment of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University, School of MedicineDepartment of Orthopedic Surgery, Shizuoka Kosei Hospital
    • , Koji FunahashiAffiliated withDepartment of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University, School of Medicine
    • , Masatoshi HayashiAffiliated withDepartment of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University, School of Medicine
    • , Daizo KatoAffiliated withDepartment of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University, School of Medicine
    • , Hiroyuki MatsubaraAffiliated withDepartment of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University, School of Medicine
    • , Naoki IshiguroAffiliated withDepartment of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University, School of MedicineDepartment of Orthopedic Surgery, Faculty and Graduate School of Medicine, Nagoya University

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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.

Keywords

Rheumatoid arthritis Remission Tocilizumab Patient-reported outcome Interleukin 6