Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel.
Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.
Eur J Clin Invest. 2020 Sep;50(9):e13268. doi: 10.1111/eci.13268. Epub 2020 Jun 19.
Mood disorders, such as anxiety and depression, are extremely prevalent among patients with rheumatoid arthritis (RA). In this study, we assessed the impact of treatment with tocilizumab (TCZ), an IL-6 antagonist, upon anxiety and depressive symptoms in a cohort of RA patients.
Study participants were adults diagnosed with RA who received a weekly subcutaneous injection of tocilizumab for 24 weeks. We used the Hamilton Depression (HDRS) and Anxiety (HAMA) scores in order to assess the severity of depression and anxiety, respectively. RA disease activity indices and depression and anxiety levels were assessed at baseline, 4 weeks and study completion.
Ultimately, 91 patients were included in the study. The mean age was 54 years, and the majority were female (79%). The mean score in all disease activity indices as well as depression and anxiety levels decreased dramatically from baseline to study completion. Sixty patients (66%) demonstrated a significant decrease in anxiety and/or depression levels. When logistic regression was performed, an HDRS score indicative of depression at study baseline demonstrated an independent association with a significant psychiatric response whilst older age and increased baseline weight were negatively associated. HAMA and HDRA scores correlated with the following RA disease activity parameters, respectively; HAQ-DI (r = .4, .42), DAS28 (r = .29, .32) and CDAI (0.28 and 0.33), all of them were statistically significant (P < .01).
This study has demonstrated a favourable impact of TCZ therapy on parameters reflecting depression and anxiety severity in patients with RA.
焦虑和抑郁等情绪障碍在类风湿关节炎（RA）患者中极为普遍。在这项研究中，我们评估了白细胞介素 6 拮抗剂托珠单抗（TCZ）治疗对 RA 患者焦虑和抑郁症状的影响。
研究参与者为被诊断患有 RA 的成年人，他们接受了为期 24 周的每周一次皮下注射托珠单抗。我们使用汉密尔顿抑郁量表（HDRS）和汉密尔顿焦虑量表（HAMA）分别评估抑郁和焦虑的严重程度。在基线、4 周和研究完成时评估 RA 疾病活动指数和抑郁及焦虑水平。
最终，91 例患者纳入研究。平均年龄为 54 岁，大多数为女性（79%）。所有疾病活动指数以及抑郁和焦虑水平的平均评分从基线到研究结束均显著下降。60 例（66%）患者的焦虑和/或抑郁水平显著下降。当进行逻辑回归分析时，研究基线时 HDRS 评分表明存在抑郁与显著精神反应具有独立相关性，而年龄较大和基线体重增加则呈负相关。HAMA 和 HDRA 评分分别与以下 RA 疾病活动参数相关；HAQ-DI（r=.4，.42）、DAS28（r=.29，.32）和 CDAI（分别为 0.28 和 0.33），均具有统计学意义（P<.01）。
这项研究表明 TCZ 治疗对 RA 患者反映抑郁和焦虑严重程度的参数具有有利影响。
