Division of Rheumatology, Johns Hopkins University, School of Medicine, Baltimore, MD.
Corrona Research Foundation, Albany, NY.
Semin Arthritis Rheum. 2017 Oct;47(2):165-169. doi: 10.1016/j.semarthrit.2017.03.024. Epub 2017 Apr 1.
Autoantibodies can be useful in predicting response to certain treatments in rheumatoid arthritis (RA). We aimed to evaluate initial response to tocilizumab (TCZ) by change in physician and patient-reported outcomes and laboratory parameters in a real-world cohort of patients with RA. We analyzed the data by autoantibody status to determine whether patients with seronegative RA had improved response to tocilizumab when compared to their seropositive counterparts.
Data from the CORRONA RA registry were analyzed. Patients were included if they were started on TCZ and had data from a follow-up visit 4-8 months after initiation, as well as having information on serologic status. Serologic status was determined by presence of anti-cyclic citrullinated peptide (CCP) antibodies. Changes in disease activity measures from baseline to follow-up visit were evaluated.
Both CCP-negative and -positive groups had statistically significant improvement in physician-reported measurements (physician rating of disease activity and joint counts), patient-reported measures (disease activity, pain, and fatigue), and acute phase reactants after 4-8 months of treatment with tocilizumab. The magnitude of improvement, however, did not differ significantly by CCP status.
Tocilizumab led to statistically significant improvement in all patient- and physician-reported measures of disease activity evaluated in this cohort of patient with RA. The response to tocilizumab did not differ by CCP status.
自身抗体可用于预测类风湿关节炎(RA)对某些治疗的反应。我们旨在通过评估 RA 患者真实队列中医生和患者报告的结局以及实验室参数的变化,来评价托珠单抗(TCZ)的初始应答。我们根据自身抗体状态分析数据,以确定与血清阳性患者相比,血清阴性 RA 患者对 TCZ 的应答是否得到改善。
对 CORRONA RA 登记处的数据进行分析。纳入标准为开始接受 TCZ 治疗且在起始后 4-8 个月有随访访视数据,同时具有血清学状态信息。血清学状态通过存在抗环瓜氨酸肽(CCP)抗体来确定。评估从基线到随访访视时疾病活动度测量值的变化。
在接受 TCZ 治疗 4-8 个月后,CCP 阴性和阳性组在医生报告的测量值(疾病活动度医生评估和关节计数)、患者报告的测量值(疾病活动度、疼痛和疲劳)以及急性期反应物方面均有统计学显著改善。然而,改善的幅度在 CCP 状态方面并无显著差异。
在本 RA 患者队列中,托珠单抗可显著改善所有患者和医生评估的疾病活动度的测量值。对托珠单抗的应答与 CCP 状态无关。