Huang Hua, Cen Han, Zhou Li, Wang Ting-Hui, Qin Wen, Xie Bin-Hua, Xiao Dong-Mei, Wu Xiu-Di, Wu Hua-Xiang
Department of Rheumatology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Preventive Medicine, Medical School of Ningbo University, Ningbo, China.
Arch Rheumatol. 2019 Apr 22;34(4):406-413. doi: 10.5606/ArchRheumatol.2019.7146. eCollection 2019 Dec.
This study aims to determine whether baseline body mass index (BMI) affects clinical response to tocilizumab (TCZ) after six months of treatment in rheumatoid arthritis (RA) patients.
In this prospective study, a total of 52 RA patients (10 males, 42 females; mean age 50.6±12.2 years; range, 23 to 73 years) receiving intravenous TCZ were consecutively recruited and followed-up for six months. BMI was calculated before initiation of TCZ treatment. The primary clinical response criterion was clinical disease activity index (CDAI) low disease activity (LDA) and the secondary clinical response criteria included CDAI remission, disease activity score based on 28 joints (DAS28)-erythrocyte sedimentation rate (ESR) LDA, DAS28-ESR remission, European League Against Rheumatism (EULAR) good response, and decreased DAS28-ESR (ΔDAS28-ESR)≥1.2.
The number of RA patients classified as normal weight, overweight, and obese according to baseline BMI was 38 (73.1%), eight (15.4%), and six (11.5%), respectively. Similar baseline BMI median levels were found between RA patients reaching CDAI LDA and non-LDA: 21.11 (18.94-23.72) versus 20.78 (20.03-22.29) (p=0.98), and non-significant difference in the proportion of responders between normal weight and overweight/obese RA patients was found (p=0.47). No significant difference was found when the secondary clinical response criteria were applied.
Our study demonstrates that BMI is not associated with clinical response to TCZ among RA patients and TCZ may be used to treat RA patients regardless of BMI levels.
本研究旨在确定类风湿关节炎（RA）患者在接受托珠单抗（TCZ）治疗6个月后，基线体重指数（BMI）是否会影响临床反应。
在这项前瞻性研究中，连续招募了52例接受静脉注射TCZ的RA患者（10例男性，42例女性；平均年龄50.6±12.2岁；范围为23至73岁），并进行了6个月的随访。在开始TCZ治疗前计算BMI。主要临床反应标准为临床疾病活动指数（CDAI）低疾病活动度（LDA），次要临床反应标准包括CDAI缓解、基于28个关节的疾病活动评分（DAS28）-红细胞沉降率（ESR）LDA、DAS28-ESR缓解、欧洲抗风湿病联盟（EULAR）良好反应以及DAS28-ESR降低（ΔDAS28-ESR）≥1.2。
根据基线BMI分类，体重正常、超重和肥胖的RA患者数量分别为38例（73.1%）、8例（15.4%）和6例（11.5%）。达到CDAI LDA和未达到CDAI LDA的RA患者之间的基线BMI中位数水平相似：21.11（18.94 - 23.72）与20.78（20.03 - 22.29）（p = 0.98），并且体重正常与超重/肥胖的RA患者之间的反应者比例无显著差异（p = 0.47）。应用次要临床反应标准时未发现显著差异。
我们的研究表明，RA患者中BMI与对TCZ的临床反应无关，无论BMI水平如何，TCZ均可用于治疗RA患者。
