Is IL-6 an appropriate target to treat spondyloarthritis patients refractory to anti-TNF therapy? A multicentre retrospective observational study.
Is IL-6 an appropriate target to treat spondyloarthritis patients refractory to anti-TNF therapy? A multicentre retrospective observational study.
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DOI：
10.1186/ar3766
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发表时间：
2012-03-09
影响因子：
4.9
通讯作者：
Club Rhumatismes et Inflammation
中科院分区：
文献类型：
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作者：
Lekpa FK;Poulain C;Wendling D;Soubrier M;De Bandt M;Berthelot JM;Gaudin P;Toussirot E;Goupille P;Pham T;Sellam J;Bruckert R;Paul M;Farrenq V;Claudepierre P;Club Rhumatismes et Inflammation
本研究的目的是在现实生活条件下评价托珠单抗在抗TNF α治疗脊柱关节炎失败患者中的安全性和疗效。要求在Rhumatismes et Inflammations网站上注册的法国风湿病学家和内科医生报告抗TNF α治疗失败后接受托珠单抗（4或8 mg/kg）治疗符合国际脊柱关节炎协会（ASAS）中轴或外周脊柱关节炎标准的活动性疾病的患者。使用标准化问卷对3个月和6个月后的安全性和有效性进行回顾性评估。获得了21例患者的数据，13例中轴脊柱关节炎（46%男性;中位年龄42岁;病程11年; HLA-B27阳性，92.3%）和8例外周脊柱关节炎（25%男性;中位年龄40岁;病程10年; HLA-B27阳性，62.5%）。3个月或6个月后，没有轴性疾病患者的BASDAI降低至少20 mm，也没有BASDAI 50应答或主要ASAS认可的疾病活动评分改善; 13例患者中有5例在第3个月时观察到ASAS认可的疾病活动评分有临床意义的改善，4例患者中有1例在第6个月时观察到。在4例外周疾病患者中实现了良好的DAS 28应答，其中1例在第3个月时达到EULAR缓解。4例患者在第6个月时仍在服用托珠单抗，包括1例EULAR缓解和1例DAS 28应答良好。托珠单抗耐受性良好，无严重不良事件。最初升高的急性期反应物在托珠单抗治疗期间下降。在抗TNF α治疗失败的患者中，托珠单抗减少了急性期反应物，但未能显著改善中轴性脊柱关节炎，对外周性脊柱关节炎的疗效不一致。
The aim of this study was to evaluate, under real-life conditions, the safety and efficacy of tocilizumab in patients having failed anti-TNFα therapy for spondyloarthritis. French rheumatologists and internal-medicine practitioners registered on the Club Rhumatismes et Inflammations website were asked to report on patients given tocilizumab (4 or 8 mg/kg) to treat active disease meeting Assessment of SpondyloArthritis International Society (ASAS) criteria for axial or peripheral spondyloarthritis, after anti-TNFα treatment failure. Safety and efficacy after 3 and 6 months were assessed retrospectively using standardised questionnaires. Data were obtained for 21 patients, 13 with axial spondyloarthritis (46% men; median age, 42 years; disease duration, 11 years; HLA-B27-positive, 92.3%) and eight with peripheral spondyloarthritis (25% men; median age, 40 years; disease duration, 10 years; HLA-B27-positive, 62.5%). No patients with axial disease had at least a 20 mm decrease in the BASDAI, nor a BASDAI50 response or major ASAS-endorsed disease activity score improvements after 3 or 6 months; an ASAS-endorsed disease activity score clinically important improvement was noted at month 3 in five of 13 patients and at month 6 in one of four patients. A good DAS28 response was achieved in four patients with peripheral disease, including one in EULAR remission at month 3. Four patients were still taking tocilizumab at month 6, including one in EULAR remission and one with a good DAS28 response. Tocilizumab was well tolerated, with no serious adverse events. Initially elevated acute-phase reactants declined during tocilizumab therapy. In patients having failed anti-TNFα therapy, tocilizumab decreased acute-phase reactants but failed to substantially improve axial spondyloarthritis and was inconsistently effective in peripheral spondyloarthritis.
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影响因子：
--
作者：
Glintborg, Bente;Ostergaard, Mikkel;Hetland, Merete Lund
通讯作者：
Hetland, Merete Lund
影响因子：
--
作者：
DOUGADOS, M;VANDERLINDEN, S;ZEIDLER, H
通讯作者：
ZEIDLER, H
影响因子：
27.4
作者：
Calin, A;Dijkmans, BAC;Fatenejad, S
通讯作者：
Fatenejad, S
影响因子：
168.9
作者：
Mease, PJ;Goffe, BS;Burge, DJ
通讯作者：
Burge, DJ
影响因子：
27.4
作者：
Glintborg, Bente;Ostergaard, Mikkel;Hetland, Merete Lund
通讯作者：
Hetland, Merete Lund