Suppression of joint destruction with subcutaneous tocilizumab for Japanese patients with rheumatoid arthritis in clinical practice

Abstract

Objectives: To investigate the efficacy of suppressing joint destruction with subcutaneous tocilizumab (TCZ-SC) for Japanese rheumatoid arthritis (RA) patients in the real-world clinical setting.

Methods: This 1-year prospective, multicenter study included 110 RA patients in whom TCZ-SC was newly initiated. Primary endpoint was the change from baseline in vdH-modified total Sharp score (mTSS) at week 52. Structural remission was defined as yearly mTSS of 0.5 or less. Disease activity was evaluated using the disease activity score (DAS28-ESR) and clinical disease activity index (CDAI).

Results: At baseline, the patients’ mean age was 58.6 years, and the mean disease duration was 10.6 years. The proportion of patients who were naïve for biologics was 44.5%, and 64.5% concomitantly received methotrexate. The yearly mTSS showed significant improvement from 9.41 before TCZ-SC initiation to −0.15 after 52 weeks. The structural remission rate was 76.1%. After 52 weeks, the DAS28-ESR and CDAI remission rates were 52% and 21%, respectively. Although the previous usage of biologics and baseline disease activity significantly affected the clinical remission, no factors with significant effects on structural remission were identified.

Conclusion: These findings support the efficacy of TCZ-SC in suppressing disease activity as well as joint destruction over a 1-year period.

Keywords:

• Joint destruction
• rheumatoid arthritis
• structural remission
• subcutaneous
• tocilizumab

Acknowledgement

This research was supported by the Fukuoka RA Biologic Treatment Study Group.

Conflict of interest

Y.N. (Yasuharu Nakashima) received speaking fees from Chugai Pharmaceutical, Mitsubishi-Tanabe Pharma, Janssen Pharmaceutical, Pfizer, Eisai, AbbVie, Bristol-Myers Squibb, Astellas, AYUMI, Hisamitsu, Taisho Toyama Pharmaceutical, Takeda Pharmaceutical (less than US$5000).

M.K. (Masakazu Kondo) received speaking fees from Chugai Pharmaceutical, Takeda Pharmaceutical, Mitsubishi-Tanabe Pharma, Janssen Pharmaceutical, Pfizer, Eisai, AbbVie, Bristol-Myers Squibb, Astellas, AYUMI (less than US$5000).

E.S. (Eisuke Shono) received speaking fees from Chugai Pharmaceutical, Mitsubishi-Tanabe Pharma, Janssen Pharmaceutical, Pfizer, Eisai, AbbVie, Bristol-Myers Squibb, Astellas, AYUMI, Takeda Pharmaceutical (less than US$5000).

T.I. (Takashi Ishinishi) received speaking fees from Chugai Pharmaceutical, Mitsubishi-Tanabe Pharma, Pfizer, Eisai, AbbVie, Bristol-Myers Squibb (less than US$5000).

H.T. (Hiroshi Tsukamoto) received speaking fees from Chugai Pharmaceutical, Mitsubishi-Tanabe Pharma, Janssen Pharmaceutical, Eisai, AbbVie, Bristol-Myers Squibb, Astellas, Nippon Kiyaku, Asahi Kasei Pharma, Eli Lilly Japan (less than US$5000).

A.M. (Akira Maeyama) received speaking fees from Mitsubishi-Tanabe Pharma, Eisai, AbbVie, Bristol-Myers Squibb (less than US$5000).

H.H. (Hiroshi Harada) received speaking fees from Chugai Pharmaceutical, Takeda Pharmaceutical, Mitsubishi-Tanabe Pharma, Janssen Pharmaceutical, Pfizer, Eisai, AbbVie, Bristol-Myers Squibb, Astellas, AYUMI, Daiichi-Sankyo (less than US$5000).

R.N. (Ryuji Nagamine) received speaking fees from Chugai Pharmaceutical, Mitsubishi-Tanabe Pharma, Janssen Pharmaceutical, Pfizer, Eisai, AbbVie, Bristol-Myers Squibb, Astellas, AYUMI, Takeda Pharmaceutical (less than US$5000).

H.J. (Hiroshi Jojima) received speaking fees from Chugai Pharmaceutical, Mitsubishi-Tanabe Pharma, Eisai, Bristol-Myers Squibb, Astellas, AYUMI (less than US$5000).

S.Y. (Seiji Yoshizawa) received speaking fees from Chugai Pharmaceutical, Takeda Pharmaceutical, Mitsubishi-Tanabe Pharma, Eisai, Astellas, Ono Pharmaceutical (less than US$5000).

T.T. (Tomomi Tsuru) received speaking fees from Chugai Pharmaceutical, Takeda, Pharmaceutical, Mitsubishi-Tanabe Pharma, Janssen Pharmaceutical, AbbVie, Bristol-Myers Squibb, Eli Lily, Teijin Pharma, Asahi Kasei Pharma, Daiichi-Sankyo, Astellas, AYUMI (less than US$5000).

T.O. (Takeshi Otsuka) received speaking fees from Chugai Pharmaceutical, Takeda Pharmaceutical, Mitsubishi-Tanabe Pharma, Janssen Pharmaceutical, Pfizer, Bristol-Myers Squibb, Astellas, AYUMI (less than US$5000).

H.M. (Hisaaki Miyahara) received speaking fees from Chugai Pharmaceutical, Takeda Pharmaceutical, Mitsubishi-Tanabe Pharma, Janssen Pharmaceutical, Pfizer, Eisai, AbbVie, Bristol-Myers Squibb, Astellas, AYUMI (less than US$5000).

E.S. (Eiichi Suematsu) received speaking fee from Chugai Pharmaceutical, Mitsubishi-Tanabe Pharma, Pfizer, Eisai, AbbVie, Bristol-Myers Squibb, Takeda Pharmaceutical (less than US$5000).

K.W. (Ken Wada) received speaking fee from Chugai Pharmaceutical, Pfizer, Daiichi-Sankyo, Asahi Kasei Pharma, Hisamitsu (less than US$5000).

Y. I. (Yasushi Inoue) received speaking fee from Chugai Pharmaceutical, Mitsubishi-Tanabe Pharma, Pfizer, AbbVie, Ono Pharmaceutical, Asahi Kasei Pharma, MSD, Daiichi-Sankyo, GlaxoSmithKline (less than US$5000).

T.F. (Takaaki Fukuda) received speaking fees from Chugai Pharmaceutical, Takeda Pharmaceutical, Mitsubishi-Tanabe Pharma, Eisai, AbbVie, Astellas, AYUMI, Teijin Pharma, Nihon Kayaku Pharmaceutical, Asahi Kasei Pharma (less than US$5000).

Others have no conflicts of interest.

Additional information

Funding

This study was funded by Chugai Pharmaceutical [UMIN 000014109], and it was not involved in the design of the study; collection, analysis, and interpretation of data; or in writing the manuscript.