AB0338 Evaluation of tocilizumab treatment continuation rate stratified by time of start of administration
Authors: Y. Yabe, T. Kojima, A. Kaneko, Y. Kanayama, Y. Hirano, T. Shioura, K. Saito, N. Asai, T. Kobayakawa, N. Ishiguro
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The utility of treating rheumatoid arthritis (RA) with a biological agent is often evaluated by the treatment continuation rate combining safety and therapeutic effect. However, there are few reports from actual clinical use upon release, and continued administration is often abandoned. <h3>Objectives</h3> Treatment continuity of tocilizumab (TCZ) in RA treatment was analyzed, stratified by year after its release, to examine whether TCZ experience affects the continuation rate. <h3>Methods</h3> Treatment continuation rates were compared in 113 patients who started administration of TCZ from May 2008 to April 2009 (initial group), 99 patients who started administration from May 2009 to April 2010 (middle group) and 93 patients who started administration from May 2010 to April 2011 (late group) to compare 12-month treatment continuation rates at hospitals affiliated with the Biologics Treatment Group, Department of Orthopedic Surgery, Nagoya University (Tsurumai Biologics Communication<sup>1)</sup>). <h3>Results</h3> Patient backgrounds were, initial group: average age 54 years, bio-naïve rate 37.2%, MTX combination rate 37.2%, average DAS28-ESR at introduction 5.7; middle group: average age 60 years, bio-naïve rate 28.3%, MTX combination rate 47.5%, average DAS28-ESR at introduction 5.6; late group: average age 59 years, bio-naïve rate 25.8%, MTX combination rate 63.4%, average DAS28-ESR at introduction 5.3. The MTX combination rate was high in the late group (p=0.001). 12-month continuation rates were 70.8% (80/113) in the initial group, 82.8% (82/99) in the middle group, 90.3% (84/93) in the late group, which was high in the late group (p=0.002). The mean DAS28-ESR after 12 months showed no difference at 2.9 in the initial group, 3.0 in the middle group and 2.8 in the late group. Discontinuations numbered 20 patients in the initial group (insufficient effect in 6 cases, adverse drug reactions in 9 cases, others (such as economic reasons) in 5 cases), 14 patients in the middle group (insufficient effect in 2 cases, adverse drug reactions in 8 cases, others in 4 cases) and 9 patients in the late group (insufficient effect in 3 cases, adverse drug reactions in 4 cases, others in 2 cases). Comparatively mild adverse drug reactions were occasionally seen in patients who discontinued, including 2 cases of decreased white blood cell count and 1 case of concern for bedsore infection in the initial group, 1 case of concern for alopecia and 1 case of decreased white blood cell count in the middle group, and 1 case of pruritis in the late group. <h3>Conclusions</h3> Although there were cases of unfamiliarity with methods of evaluating effects and dealing with mild adverse drug reactions upon initial release, the treatment continuation rate has been high since the method of usage has become widespread. <h3>References</h3> Kojima T, Kaneko A, Hirano Y, Ishikawa H, Miyake H, Oguchi T, et al. Study protocol of a multicenter registry of patients with rheumatoid arthritis starting biologic therapy in Japan: Tsurumai Biologics Communication Registry (TBCR) Study. Mod Rheumatol. 2011. <h3>Disclosure of Interest</h3> Y. Yabe Speakers bureau: Eisai Co. Ltd, Abbot Japan Co. Ltd, Mitsubishi Tanabe Pharma Corporation, Pfizer Japan, and Chugai Phamaceutical Co. Ltd., T. Kojima Speakers bureau: Eisai Co. Ltd, Abbot Japan Co. Ltd, Mitsubishi Tanabe Pharma Corporation, Daiichi Sankyo Pharmaceutical, Pfizer Japan, Takeda Pharmaceutical, andChugai Phamaceutical Co. Ltd, A. Kaneko Speakers bureau: Eisai Co. Ltd, Abbot Japan Co. Ltd, Mitsubishi TanabePharma Corporation and Chugai Phamaceutical Co. Ltd., Y. Kanayama: None Declared, Y. Hirano: None Declared, T. Shioura: None Declared, K. Saito: None Declared, N. Asai: None Declared, T. Kobayakawa: None Declared, N. Ishiguro Speakers bureau: EisaiCo. Ltd, Abbot Japan Co. Ltd, Mitsubishi Tanabe Pharma Corporation, Daiichi Sankyo Pharmaceutical, Pfizer Japan, Takeda Pharmaceutical, and Chugai Phamaceutical Co. Ltd.