Efficacy and tolerability of six-week extended dosing interval with tocilizumab therapy in a prospective cohort as remission maintenance in patients with rheumatoid arthritis

Jun Kikuchi, Tsuneo Kondo, Akiko Shibata, Ryota Sakai, Yusuke Okada, Kentaro Chino, Ayumi Okuyama, Takahiko Kurasawa, Hirofumi Takei, Koichi Amano

Research output: Contribution to journalArticle

3 Citations (Scopus)


Objectives: To prospectively evaluate the efficacy and tolerability of a six-week extended dosing interval with tocilizumab (TCZ) in patients with rheumatoid arthritis (RA) in sustained remission. Methods: Patients who received over six doses of intravenous TCZ in clinical remission (disease activity score [DAS] 28 – erythrocyte sedimentation rate [ESR] ≤ 2.6) maintained over 3 months between December 2013 and December 2015 were included. Flare was defined as DAS28-ESR >3.2 at two consecutive visits. Results: Twenty-five patients were enrolled; 87.5% achieved clinical remission at week 54 after six-week extension and 95.5% achieved a van der Heijde modified total Sharp score (ΔmTSS) ≤0.5. The Health Assessment Questionnaire Disability Index (HAQ-DI) did not increase during 54 weeks. HAQ-DI at baseline and ΔDAS28-ESR at week six positively correlated with increase in DAS28-ESR at week 54. ΔSwollen joint count at week six positively correlated with ΔmTSS at week 54. A total of 12 adverse events occurring in 10 patients did not lead to cessation of TCZ except for one case of recurrent lymphoproliferative disorder at week five. Conclusion: A six-week extended dosing interval of TCZ for patients with RA in sustained remission is proposed as an acceptable treatment option for maintaining efficacy and tolerability.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalModern Rheumatology
Publication statusAccepted/In press - 2017 Aug 29



  • Maintenance
  • remission
  • rheumatoid arthritis
  • tapering
  • tocilizumab

ASJC Scopus subject areas

  • Rheumatology

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