Department of Rheumatology, Hikarigaoka Spellman Hospital, 6-7-1 Higashisendai, Miyagino-ku, Sendai 983-0833, Japan.
Rheumatol Int. 2010 Jun;30(8):1041-8. doi: 10.1007/s00296-009-1095-0. Epub 2009 Aug 22.
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.
先前的临床研究表明，托珠单抗单药治疗类风湿关节炎（RA）非常有效。本文的目的是报告托珠单抗在真实临床实践中治疗活动期 RA 患者的疗效和安全性。共有 61 例 RA 患者接受了托珠单抗治疗。在给他们用药之前，我们彻底治疗了他们的任何合并症，尤其是感染。我们提供了感染控制和预防方面的指导。患者的平均年龄为 60.9±12.4 岁，平均病程为 10.9±9.2 年。患者继续使用皮质类固醇、甲氨蝶呤和他克莫司，就像治疗前一样，但停用了之前使用的任何其他药物。最初，使用红细胞沉降率的 28 关节疾病活动评分平均值为 4.75±1.15，在接受两剂治疗后降至 2.21±0.97（n=50）。在接受四剂治疗后，缓解率为 83.8%（31/37）。所有患者对治疗反应良好，托珠单抗的疗效在治疗过程中没有下降。即使在真实的临床环境中，托珠单抗治疗也可以迅速诱导大部分 RA 患者缓解，且通常安全且耐受良好。托珠单抗似乎是治疗 RA 的一线选择。
