AB0517 Tocilizumab monotherapy in the clinical practice: Retrospective analysis of a cohort of patients with active rheumatoid arthritis in catalonia, spain
Authors: B. Magallares, E. Quesada, M.P. Lisbona, J. Calvet, R. Sanmarti, D. Reina, J. Narvaez, C. Diaz-Torne, S. Marsal, J. Maymo, M. Garcia-Manrique, M. Moreno, V. Hernández, H. Corominas, J.M. Nolla
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> New data indicates that Tocilizumab (TCZ) plus Methotrexate (MTX) does not have superior clinical efficacy to TCZ alone. <h3>Objectives</h3> To evaluate demographic and clinical features of a cohort of patients with rheumatoid arthritis (RA) treated with TCZ monotherapy in the clinical practice <h3>Methods</h3> Demographic and clinical data of 81 patients treated with TCZ monotherapy were assessed in 7 Spanish centers. Duration of RA, previous treatments, reason for DMARDs discontinuation and adverse events were included. Clinical activity assessed by Disease Activity Score (DAS) 28-ESR index, and laboratory data were done at weeks 0, 12 and 24 (W0, W12 and W24). Statistical analysis was performed using T-Student and Wilcoxon Tests <h3>Results</h3> A total of 81 patients were evaluated. Mean age: 57.7±12.7 years and 81.2% females. At baseline, patients had mean disease duration of 13.2±9.4 years. 69.1% and 58.0% were Rheumatoid Factor and anti-CCP positive. Patients had been treated previously with Methotrexate (82.1%), Leflunomide (50.0%), hydroxycloroquine (21.8%), Gold Salts (16.7%), Cyclosporine (11.5%) and Salazopyrine (7.5%). Reasons for DMARD discontinuation previous TCZ monotherapy were: adverse effects 59.2%, inefficacy 26.3% and patient decision 7.9%. Patients had been treated with 3 (16.0%), 2 (21.0%) and 1 (30.9%) biological therapies before starting TCZ. TCZ was the first biological therapy in 12.3% of patients. Biological treatments previous TCZ were Etanercept (64.7%), Adalimumab (52.9%), Infliximab (47.1%), Rituximab (32.4%), Abatacept (25.0%) and Anakinra (5.9%). The mean (±SD) CRP, ESR, DAS28, SJC and TJC at W0 were 10.2±17.3 mg/dl, 41.9±31.4, 5.7±1.4, 7.7±6.9 and 11.0±7.6 respectively. At W12 and W24, 29.0% (n=18/62), 42.1% (n=24/57) of patients achieved DAS28 remission criteria and 46.8% (n=29/62), 59.6% (n=34/57) low disease activity respectively. We find a relationship between disease duration and the probability to achieve the remission at W12: T-test for equality of means: 15.2 (group no-remission) vs 10.1 years (group of remission), p=0.046. We also find relationship between the number of previous biological therapies and the probability to achieve the low disease activity at W12. T-test: 2.6 (group no-low disease activity) vs 1.7 (group of low disease activity), p=0.023. This relationship disappeared at W24 in both cases <h3>Conclusions</h3> Our series of RA patients show the efficacy of Tocilizumab treatment administered as monotherapy in clinical practice. The main reason for using Tocilizumab monotherapy has been intolerance to DMARDs <h3>Disclosure of Interest</h3> B. Magallares: None Declared, E. Quesada: None Declared, M. P. Lisbona: None Declared, J. Calvet: None Declared, R. Sanmarti Consultant for: Roche, D. Reina: None Declared, J. Narvaez: None Declared, C. Diaz-Torne: None Declared, S. Marsal: None Declared, J. Maymo: None Declared, M. Garcia-Manrique: None Declared, M. Moreno: None Declared, V. Hernández: None Declared, H. Corominas Consultant for: Roche, J. M. Nolla Consultant for: Roche