Tocilizumab can efficiently prevent bone destruction in patients with recent-onset rheumatoid arthritis

Abstract

Objectives

To assess whether tocilizumab (TCZ) can prevent bone destruction in patients with recent-onset rheumatoid arthritis (RA).

Methods

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.

Results

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.

Conclusion

TCZ can efficiently prevent bone destruction in patients with recent-onset RA.

Keywords:

• Bone destruction
• interleukin-6
• rheumatoid arthritis
• tocilizumab

Acknowledgments

The author thanks Editage (www.editage.jp) for English language editing.

Conflict of interest

Y. H. has received speaking fees from Chugai.

Additional information

Funding

This study was supported by a clinical research fund from Hikarigaoka Spellman Hospital.