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Patient satisfaction and clinical effectiveness of switching from intravenous tocilizumab to subcutaneous tocilizumab in patients with juvenile idiopathic arthritis: an observational study

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Abstract

Introduction

Juvenile idiopathic arthritis (JIA) is a heterogeneous group of idiopathic inflammatory arthritis affecting children younger than 16 years of age. Tocilizumab (TCZ) is a humanized anti-interleukin 6 (IL-6) receptor antibody that was approved for systemic and polyarticular JIA patients. However, the studies regarding patients’ satisfaction while receiving TCZ therapy is scarce. Herein, we aimed to evaluate the effect of subcutaneous (SC) TCZ administration on patient satisfaction and disease control of JIA patients.

Methods

All JIA patients receiving TCZ were included in the study. Clinical features, laboratory findings and JADAS71 scores were recorded at baseline and every 3 months during follow-up. Nine of the patients on intravenous (IV) TCZ treatment were switched to SC form. All patients receiving TCZ-SC were questioned by a clinical nurse specialist (CNS) to assess patient satisfaction.

Results

A total of 39 patients receiving TCZ were included in the study. Among them, treatment of nine patients (five female, four male) was switched to SC form with a median of 11.5 (8–69) months after initiation of TCZ. Patients were stable both clinically and in laboratory means at the 3rd month of TCZ-SC treatment. There was no deterioration in terms of active joint counts, physician’s VAS, patient’s VAS and JADAS71. According to patient satisfaction questionnaire, eight of the patients felt satisfied with SC administrations in terms of life quality, school success and reduced school absenteeism. However, one patient did not agree that the SC form is as effective as IV form and wanted to continue with IV form.

Conclusion

TCZ is an effective treatment option in JIA and switching from IV to SC route when necessary is found to be an effective and acceptable alternative by the patients as well.

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Acknowledgements

We sincerely thank to Begüm Ayaz for kind help while writing the draft manuscript.

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Authors and Affiliations

  1. Department of Pediatric Rheumatology, Istanbul University Medical School, Fatih, Istanbul, Turkey

    Nuray Aktay Ayaz & Figen Çakmak

  2. Department of Pediatric Rheumatology, Kanuni Sultan Süleyman Research and Training Hospital, University of Health Sciences, Istanbul, Turkey

    Şerife Gül Karadağ, Rahime Koç, Fatma Gül Demirkan & Hafize Emine Sönmez

Authors
  1. Nuray Aktay Ayaz
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  2. Şerife Gül Karadağ
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  3. Rahime Koç
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  4. Fatma Gül Demirkan
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  5. Figen Çakmak
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  6. Hafize Emine Sönmez
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Contributions

NAA conceptualized and designed the study, drafted the initial manuscript, and had full access to all the data in the study; SGK, RK, FGD, FÇ, and HES designed the study, conducted the data analyses, drafted the initial manuscript, and had full access to all the data in the study. All authors reviewed and revised the manuscript and approved the final version of the manuscript. Congress abstract publications: None.

Corresponding author

Correspondence to Nuray Aktay Ayaz.

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Conflict of interest

The authors have declared no conflicts of interest. None of the authors had relationships with pharm agencies.

Ethical approval

The study was reviewed and approved by the local ethical review committee (Ethics approval number: KAEK/2019.01.06). Written informed consents were signed by parents and patients.

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Ayaz, N.A., Karadağ, Ş.G., Koç, R. et al. Patient satisfaction and clinical effectiveness of switching from intravenous tocilizumab to subcutaneous tocilizumab in patients with juvenile idiopathic arthritis: an observational study. Rheumatol Int 40, 1111–1116 (2020). https://doi.org/10.1007/s00296-020-04596-3

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  • DOI: https://doi.org/10.1007/s00296-020-04596-3

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