In rheumatoid arthritis patients treated with tocilizumab, the rate of clinical disease activity index (CDAI) remission at 24 weeks is superior in those with higher titers of IgM-rheumatoid factor at baseline
In rheumatoid arthritis patients treated with tocilizumab, the rate of clinical disease activity index (CDAI) remission at 24 weeks is superior in those with higher titers of IgM-rheumatoid factor at baseline
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DOI：
10.1007/s10165-010-0409-0
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发表时间：
2011-08-01
影响因子：
2.2
通讯作者：
Eguchi, Katsumi
中科院分区：
文献类型：
--
作者：
Kawashiri, Shin-ya;Kawakami, Atsushi;Eguchi, Katsumi
我们的目的是评估托珠单抗在类风湿关节炎（RA）患者中的疗效，使用临床疾病活动指数（CDAI），并确定与CDAI缓解相关的基线变量。入组了58例活动性RA患者。我们试图评估基线变量是否与24周时CDAI缓解相关。58例患者中有22例（37.9%）接受了肿瘤坏死因子（TNF）抑制剂治疗。托珠单抗治疗24周的继续率为87.9%。基线时IgM类风湿因子（RF）和抗环瓜氨酸肽（抗CCP）抗体的血清阳性率均为91.4%。24周时CDAI缓解率为20.7%。我们选择的基线变量包括年龄、性别、疾病持续时间、糖皮质激素的合并使用、甲氨蝶呤（MTX）的合并使用、既往抗TNF治疗、抗CCP抗体滴度（高或低至中位数），IgM-RF滴度（高或低至中位数）和CDAI，并发现高滴度的IgM-RF是与CDAI缓解相关的唯一变量，根据单因素和Logistic回归分析。这是一项新发现，与抗TNF治疗的既往观察结果相比，可能对托珠单抗具有特异性。
We aimed to evaluate the efficacy of tocilizumab in patients with rheumatoid arthritis (RA), using the clinical disease activity index (CDAI), and to determine the baseline variables associated with CDAI remission. Fifty-eight patients with active RA were enrolled. We tried to evaluate whether baseline variables were associated with CDAI remission at 24 weeks. Twenty-two of the 58 patients (37.9%) had received tumor necrosis factor (TNF) inhibitors. The continuation rate of tocilizumab at 24 weeks was 87.9%. The seropositivity rates of IgM-rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies at baseline were both 91.4%. The rate of CDAI remission at 24 weeks was 20.7%. We selected baseline variables including age, gender, duration of disease, concomitant use of glucocorticoids, concomitant use of methotrexate (MTX), previous anti-TNF therapy, titer of anti-CCP antibodies (high or low toward median), titer of IgM-RF (high or low toward median), and CDAI, and found that a high titer of IgM-RF was the only variable to be associated with CDAI remission, according to univariate and logistic regression analyses. This is a new finding, and may be specific to tocilizumab as compared with previous observations in anti-TNF therapy.