TY - JOUR
T1 - Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation
T2 - A post hoc analysis of the SURPRISE study
AU - Kato, Masaru
AU - Kaneko, Yuko
AU - Tanaka, Yoshiya
AU - Inoo, Masayuki
AU - Kobayashi-Haraoka, Hitomi
AU - Amano, Koichi
AU - Miyata, Masayuki
AU - Murakawa, Yohko
AU - Yasuoka, Hidekata
AU - Hirata, Shintaro
AU - Nagasawa, Hayato
AU - Tanaka, Eiichi
AU - Miyasaka, Nobuyuki
AU - Yamanaka, Hisashi
AU - Yamamoto, Kazuhiko
AU - Yokota, Isao
AU - Atsumi, Tatsuya
AU - Takeuchi, Tsutomu
N1 - Publisher Copyright:
© 2019, © 2019 Japan College of Rheumatology. Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/5/3
Y1 - 2020/5/3
N2 - Objectives: To identify predictive factors for remission by tocilizumab monotherapy in rheumatoid arthritis (RA) patients. Methods: This is a post hoc analysis of the SURPRISE study, a 2-year randomized, controlled study comparing the efficacy of tocilizumab with (ADD-ON) and without methotrexate (SWITCH). The primary endpoint was DAS28-ESR remission (<2.6) at week 24. The change in modified total Sharp score from baseline to week 52 (ΔmTSS/year) was also assessed as an endpoint. The effect of clinical parameters at baseline on remission was estimated by logistic regression analysis. Results: In SWITCH (n = 96), CRP, SAA, RF, and DAS28 at baseline showed predictive value for DAS28 remission in unadjusted analysis. Adjusted analysis confirmed SAA and DAS28 as predictive factors, with SAA having the highest value (ROC-AUC = 0.731). Furthermore, structural remission (ΔmTSS/year ≤ 0.5) rate was significantly higher in patients with SAA of < 50.0 μg/mL than other patients. In contrast, in ADD-ON (n = 98), only DAS28 showed predictive value for DAS28 remission. In patients with SAA < 50.0 μg/mL, both DAS28 remission and structural remission rate were comparable between SWITCH and ADD-ON. Conclusion: RA patients with low SAA levels at baseline may benefit similarly from tocilizumab with and without methotrexate. Trial registration number: NCT01120366.
AB - Objectives: To identify predictive factors for remission by tocilizumab monotherapy in rheumatoid arthritis (RA) patients. Methods: This is a post hoc analysis of the SURPRISE study, a 2-year randomized, controlled study comparing the efficacy of tocilizumab with (ADD-ON) and without methotrexate (SWITCH). The primary endpoint was DAS28-ESR remission (<2.6) at week 24. The change in modified total Sharp score from baseline to week 52 (ΔmTSS/year) was also assessed as an endpoint. The effect of clinical parameters at baseline on remission was estimated by logistic regression analysis. Results: In SWITCH (n = 96), CRP, SAA, RF, and DAS28 at baseline showed predictive value for DAS28 remission in unadjusted analysis. Adjusted analysis confirmed SAA and DAS28 as predictive factors, with SAA having the highest value (ROC-AUC = 0.731). Furthermore, structural remission (ΔmTSS/year ≤ 0.5) rate was significantly higher in patients with SAA of < 50.0 μg/mL than other patients. In contrast, in ADD-ON (n = 98), only DAS28 showed predictive value for DAS28 remission. In patients with SAA < 50.0 μg/mL, both DAS28 remission and structural remission rate were comparable between SWITCH and ADD-ON. Conclusion: RA patients with low SAA levels at baseline may benefit similarly from tocilizumab with and without methotrexate. Trial registration number: NCT01120366.
KW - Monotherapy
KW - prediction
KW - remission
KW - serum amyloid A
KW - tocilizumab
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U2 - 10.1080/14397595.2019.1621026
DO - 10.1080/14397595.2019.1621026
M3 - Article
C2 - 31106666
AN - SCOPUS:85067551725
SN - 1439-7595
VL - 30
SP - 442
EP - 449
JO - Modern Rheumatology
JF - Modern Rheumatology
IS - 3
ER -