Early aggressive intervention with tocilizumab for rheumatoid arthritis increases remission rate defined using a Boolean approach in clinical practice

Toshihisa Kojima, Atsushi Kaneko, Yuji Hirano, Hisato Ishikawa, Hiroyuki Miyake, Hideki Takagi, Yuichiro Yabe, Takefumi Kato, Kenya Terabe, Naoki Fukaya, Hiroki Tsuchiya, Tomone Shioura, Koji Funahashi, Masatoshi Hayashi, Daizo Kato, Hiroyuki Matsubara, Naoki Ishiguro
Modern Rheumatology 2012, 22 (3): 370-5
The goal of treating rheumatoid arthritis (RA) should be remission, for which a new definition was proposed in 2011. To determine which patients can achieve the new Boolean-based definition of remission in clinical practice, we analyzed factors associated with remission in 123 patients who received tocilizumab for 52 weeks. We found that patients with short disease duration (<4.8 years) had a significantly higher rate of remission (31.7%) than those with longer disease duration, and patient global assessment was the most important factor for achieving remission. Multivariate analysis revealed the following predictors of remission: short disease duration [<4.8 years; odds ratio (OR) 2.5, 95% confidence interval (CI) 1.4-4.7] and lower disease activity [28-joint disease activity score-erythrocyte sedimentation rate (DAS28-ESR) <5.23; OR 2.5, 95% CI 1.2-5.1). In this study, we showed that remission, as newly defined using a Boolean approach, is a realistic goal for patients treated with tocilizumab with short disease duration in real-world clinical practice.


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