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Clinical efficacy of tocilizumab in patients with active rheumatoid arthritis in real clinical practice.

Hirabayashi Y, Ishii T, Harigae H - Rheumatol. Int. (2009)

Bottom Line: The previous clinical studies have demonstrated tocilizumab monotherapy to be highly effective in rheumatoid arthritis (RA).All patients responded well to the therapy and there was no decrease in the efficacy of tocilizumab during the treatment.Even in the real clinical setting, treatment with tocilizumab can rapidly induce remission in RA in a high proportion of patients and is generally safe and well tolerated.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology, Hikarigaoka Spellman Hospital, 6-7-1 Higashisendai, Miyagino-ku, Sendai 983-0833, Japan. y_hirabayashi@doctor.nifty.jp

ABSTRACT
The previous clinical studies have demonstrated tocilizumab monotherapy to be highly effective in rheumatoid arthritis (RA). The objectives of the present article are to report the efficacy and safety of tocilizumab in patients with active RA in real clinical practice. In total, 61 patients with RA were treated with tocilizumab. Any comorbidities they had, especially infections, were treated thoroughly before they were given the drug. We provided guidance on infection control and prevention. Mean age of the patients was 60.9 +/- 12.4 years, and their mean disease duration 10.9 +/- 9.2 years. The patients remained on steroids, methotrexate, and tacrolimus as before, but were taken off any other drugs they had been using prior to the treatment. Mean of the 28-joint disease activity score using erythrocyte sedimentation rate was 4.75 +/- 1.15 initially and fell to 2.21 +/- 0.97 after two doses (n = 50). After four doses, the remission rate was 83.8% (31/37). All patients responded well to the therapy and there was no decrease in the efficacy of tocilizumab during the treatment. Even in the real clinical setting, treatment with tocilizumab can rapidly induce remission in RA in a high proportion of patients and is generally safe and well tolerated. Tocilizumab would seem to be promising as a first-line choice for the treatment of RA.

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Related in: MedlinePlus

Change in white blood cell counts and platelet counts (a), hemoglobin (b), alanine transaminase (c), and total cholesterol (d). Mean values shown. Bars indicate SD. “n” indicates the number of patients. (See the legend for Fig. 1.)
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Fig4: Change in white blood cell counts and platelet counts (a), hemoglobin (b), alanine transaminase (c), and total cholesterol (d). Mean values shown. Bars indicate SD. “n” indicates the number of patients. (See the legend for Fig. 1.)

Mentions: The mean leukocyte count was 8,400 ± 2,990/μl at baseline, but went down to around 6,000/μl after the first dose. There was no progressive fall as seen in myelosuppression and no significant increase in infections was recorded either (Fig. 4a). Likewise, the mean platelet count of 315,000 ± 74,000/μl at baseline went to around 220,000/μl after the first dose (Fig. 4a).Fig. 4


Clinical efficacy of tocilizumab in patients with active rheumatoid arthritis in real clinical practice.

Hirabayashi Y, Ishii T, Harigae H - Rheumatol. Int. (2009)

Change in white blood cell counts and platelet counts (a), hemoglobin (b), alanine transaminase (c), and total cholesterol (d). Mean values shown. Bars indicate SD. “n” indicates the number of patients. (See the legend for Fig. 1.)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2877340&req=5

Fig4: Change in white blood cell counts and platelet counts (a), hemoglobin (b), alanine transaminase (c), and total cholesterol (d). Mean values shown. Bars indicate SD. “n” indicates the number of patients. (See the legend for Fig. 1.)
Mentions: The mean leukocyte count was 8,400 ± 2,990/μl at baseline, but went down to around 6,000/μl after the first dose. There was no progressive fall as seen in myelosuppression and no significant increase in infections was recorded either (Fig. 4a). Likewise, the mean platelet count of 315,000 ± 74,000/μl at baseline went to around 220,000/μl after the first dose (Fig. 4a).Fig. 4

Bottom Line: The previous clinical studies have demonstrated tocilizumab monotherapy to be highly effective in rheumatoid arthritis (RA).All patients responded well to the therapy and there was no decrease in the efficacy of tocilizumab during the treatment.Even in the real clinical setting, treatment with tocilizumab can rapidly induce remission in RA in a high proportion of patients and is generally safe and well tolerated.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology, Hikarigaoka Spellman Hospital, 6-7-1 Higashisendai, Miyagino-ku, Sendai 983-0833, Japan. y_hirabayashi@doctor.nifty.jp

ABSTRACT
The previous clinical studies have demonstrated tocilizumab monotherapy to be highly effective in rheumatoid arthritis (RA). The objectives of the present article are to report the efficacy and safety of tocilizumab in patients with active RA in real clinical practice. In total, 61 patients with RA were treated with tocilizumab. Any comorbidities they had, especially infections, were treated thoroughly before they were given the drug. We provided guidance on infection control and prevention. Mean age of the patients was 60.9 +/- 12.4 years, and their mean disease duration 10.9 +/- 9.2 years. The patients remained on steroids, methotrexate, and tacrolimus as before, but were taken off any other drugs they had been using prior to the treatment. Mean of the 28-joint disease activity score using erythrocyte sedimentation rate was 4.75 +/- 1.15 initially and fell to 2.21 +/- 0.97 after two doses (n = 50). After four doses, the remission rate was 83.8% (31/37). All patients responded well to the therapy and there was no decrease in the efficacy of tocilizumab during the treatment. Even in the real clinical setting, treatment with tocilizumab can rapidly induce remission in RA in a high proportion of patients and is generally safe and well tolerated. Tocilizumab would seem to be promising as a first-line choice for the treatment of RA.

Show MeSH
Related in: MedlinePlus