Department of Rheumatology, Hikarigaoka Spellman Hospital, Sendai, Japan.
Mod Rheumatol. 2021 Sep;31(5):966-971. doi: 10.1080/14397595.2020.1859674. Epub 2021 Jan 18.
To assess whether tocilizumab (TCZ) can prevent bone destruction in patients with recent-onset rheumatoid arthritis (RA).
DAS28-ESR and van der Heijde-modified Sharp score (mTSS) were evaluated in 50 patients who received TCZ within 1 year from the onset of RA. TCZ was consecutively administered during the observation period within the first 2 years. In 15 patients, mTSS could be evaluated at 5 years.
The mean DAS28-ESR at baseline, 1, 2, and 5 years was 4.86, 1.29, 1.19, and 1.18, respectively. The change in mTSS (ΔmTSS) between baseline and 2 years was -0.33. The structural remission rates (ΔmTSS/year ≤0.5) were 91.8% and 92.7% during the first and second years, respectively. Only one increase in erosion score was observed in the first year in 2 patients and the erosion score of all patients did not increase in the second year. In 15 patients, the ΔmTSS over 5 years was 0.80, corresponding to 0.16 per year. The structural remission rate at 5 years (ΔmTSS ≤2.5) was 93.3%. The erosion score was 0 in all 15 patients at 5 years, indicating that bone destruction did not become apparent.
TCZ can efficiently prevent bone destruction in patients with recent-onset RA.
评估托珠单抗（TCZ）是否可预防发病后 1 年内的类风湿关节炎（RA）患者的骨破坏。
在 50 例发病后 1 年内开始接受 TCZ 治疗的 RA 患者中，评估 DAS28-ESR 和 van der Heijde 改良 Sharp 评分（mTSS）。在观察期内，TCZ 在发病后 2 年内连续给药。在 15 例患者中，可以评估发病后 5 年的 mTSS。
基线、1 年、2 年和 5 年的平均 DAS28-ESR 分别为 4.86、1.29、1.19 和 1.18。基线与 2 年之间 mTSS 的变化（ΔmTSS）为-0.33。第 1 年和第 2 年的结构缓解率（ΔmTSS/年≤0.5）分别为 91.8%和 92.7%。在第 1 年，有 2 例患者的侵蚀评分仅增加 1 分，而所有患者的侵蚀评分在第 2 年均未增加。在 15 例患者中，5 年的 ΔmTSS 为 0.80，相当于每年 0.16。5 年的结构缓解率（ΔmTSS≤2.5）为 93.3%。在第 5 年，所有 15 例患者的侵蚀评分均为 0，表明骨破坏没有明显进展。
TCZ 可有效预防发病后 1 年内 RA 患者的骨破坏。
