Abstract
Objectives To investigate the duration of remission and low disease activity (LDA) after cessation of tocilizumab (TCZ) treatment in rheumatoid arthritis patients who showed remission or LDA as assessed by DAS28 in response to preceding TCZ monotherapy, and to explore the factors contributing to prolonged efficacy duration. Methods Disease activity was monitored for 56 weeks. The rate of continued efficacy was estimated by Kaplan-Meier curves. Results A total of 187 patients were eligible. At baseline of this study, median disease duration was 7.8 years, preceding TCZ treatment period was 4.0 years and DAS28 was 1.5. The rate of continued LDA at 52 weeks was 13.4 % according to the Kaplan-Meier estimate. 19 patients (10 %) were completely drug-free and 17 patients (9.1 %) fulfilled DAS28 remission at 52 weeks. Multivariate Cox regression analysis identified low serum IL-6 and normalisation of MMP-3 levels at cessation of TCZ as independent predictive markers for longer duration of LDA. In patients with low serum IL-6 (<12.9 pg/mL) and normal MMP-3 levels, the rate of continued LDA reached 38.0 % at 52 weeks. Conclusions TCZ monotherapy may induce biologics-free remission or LDA without concomitant use of synthetic DMARDs. Serum levels of IL-6 and MMP-3 are useful markers for identifying patients who could discontinue TCZ without acute disease flare.
| Original language | English |
|---|---|
| Pages (from-to) | 17-25 |
| Number of pages | 9 |
| Journal | Modern Rheumatology |
| Volume | 24 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2014 |
Fingerprint
Keywords
- Drug free
- Duration of efficacy
- Interleukin 6
- Matrix metalloproteinase 3
- Rheumatoid arthritis
- Tocilizumab
ASJC Scopus subject areas
- Rheumatology
Cite this
Drug free REmission/low disease activity after cessation of tocilizumab (Actemra) Monotherapy (DREAM) study. / Nishimoto, Norihiro; Amano, Koichi; Hirabayashi, Yasuhiko; Horiuchi, Takahiko; Ishii, Tomonori; Iwahashi, Mitsuhiro; Iwamoto, Masahiro; Kohsaka, Hitoshi; Kondo, Masakazu; Matsubara, Tsukasa; Mimura, Toshihide; Miyahara, Hisaaki; Ohta, Shuji; Saeki, Yukihiko; Saito, Kazuyoshi; Sano, Hajime; Takasugi, Kiyoshi; Takeuchi, Tsutomu; Tohma, Shigeto; Tsuru, Tomomi; Ueki, Yukitaka; Yamana, Jiro; Hashimoto, Jun; Matsutani, Takaji; Murakami, Miho; Takagi, Nobuhiro.
In: Modern Rheumatology, Vol. 24, No. 1, 2014, p. 17-25.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Drug free REmission/low disease activity after cessation of tocilizumab (Actemra) Monotherapy (DREAM) study
AU - Nishimoto, Norihiro
AU - Amano, Koichi
AU - Hirabayashi, Yasuhiko
AU - Horiuchi, Takahiko
AU - Ishii, Tomonori
AU - Iwahashi, Mitsuhiro
AU - Iwamoto, Masahiro
AU - Kohsaka, Hitoshi
AU - Kondo, Masakazu
AU - Matsubara, Tsukasa
AU - Mimura, Toshihide
AU - Miyahara, Hisaaki
AU - Ohta, Shuji
AU - Saeki, Yukihiko
AU - Saito, Kazuyoshi
AU - Sano, Hajime
AU - Takasugi, Kiyoshi
AU - Takeuchi, Tsutomu
AU - Tohma, Shigeto
AU - Tsuru, Tomomi
AU - Ueki, Yukitaka
AU - Yamana, Jiro
AU - Hashimoto, Jun
AU - Matsutani, Takaji
AU - Murakami, Miho
AU - Takagi, Nobuhiro
PY - 2014
Y1 - 2014
N2 - Objectives To investigate the duration of remission and low disease activity (LDA) after cessation of tocilizumab (TCZ) treatment in rheumatoid arthritis patients who showed remission or LDA as assessed by DAS28 in response to preceding TCZ monotherapy, and to explore the factors contributing to prolonged efficacy duration. Methods Disease activity was monitored for 56 weeks. The rate of continued efficacy was estimated by Kaplan-Meier curves. Results A total of 187 patients were eligible. At baseline of this study, median disease duration was 7.8 years, preceding TCZ treatment period was 4.0 years and DAS28 was 1.5. The rate of continued LDA at 52 weeks was 13.4 % according to the Kaplan-Meier estimate. 19 patients (10 %) were completely drug-free and 17 patients (9.1 %) fulfilled DAS28 remission at 52 weeks. Multivariate Cox regression analysis identified low serum IL-6 and normalisation of MMP-3 levels at cessation of TCZ as independent predictive markers for longer duration of LDA. In patients with low serum IL-6 (<12.9 pg/mL) and normal MMP-3 levels, the rate of continued LDA reached 38.0 % at 52 weeks. Conclusions TCZ monotherapy may induce biologics-free remission or LDA without concomitant use of synthetic DMARDs. Serum levels of IL-6 and MMP-3 are useful markers for identifying patients who could discontinue TCZ without acute disease flare.
AB - Objectives To investigate the duration of remission and low disease activity (LDA) after cessation of tocilizumab (TCZ) treatment in rheumatoid arthritis patients who showed remission or LDA as assessed by DAS28 in response to preceding TCZ monotherapy, and to explore the factors contributing to prolonged efficacy duration. Methods Disease activity was monitored for 56 weeks. The rate of continued efficacy was estimated by Kaplan-Meier curves. Results A total of 187 patients were eligible. At baseline of this study, median disease duration was 7.8 years, preceding TCZ treatment period was 4.0 years and DAS28 was 1.5. The rate of continued LDA at 52 weeks was 13.4 % according to the Kaplan-Meier estimate. 19 patients (10 %) were completely drug-free and 17 patients (9.1 %) fulfilled DAS28 remission at 52 weeks. Multivariate Cox regression analysis identified low serum IL-6 and normalisation of MMP-3 levels at cessation of TCZ as independent predictive markers for longer duration of LDA. In patients with low serum IL-6 (<12.9 pg/mL) and normal MMP-3 levels, the rate of continued LDA reached 38.0 % at 52 weeks. Conclusions TCZ monotherapy may induce biologics-free remission or LDA without concomitant use of synthetic DMARDs. Serum levels of IL-6 and MMP-3 are useful markers for identifying patients who could discontinue TCZ without acute disease flare.
KW - Drug free
KW - Duration of efficacy
KW - Interleukin 6
KW - Matrix metalloproteinase 3
KW - Rheumatoid arthritis
KW - Tocilizumab
UR - http://www.scopus.com/inward/record.url?scp=84897569032&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84897569032&partnerID=8YFLogxK
U2 - 10.3109/14397595.2013.854079
DO - 10.3109/14397595.2013.854079
M3 - Article
C2 - 24261754
AN - SCOPUS:84897569032
VL - 24
SP - 17
EP - 25
JO - Modern Rheumatology
JF - Modern Rheumatology
SN - 1439-7595
IS - 1
ER -