Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation: A post hoc analysis of the SURPRISE study

Masaru Kato, Yuko Kaneko, Yoshiya Tanaka, Masayuki Inoo, Hitomi Kobayashi-Haraoka, Koichi Amano, Masayuki Miyata, Yohko Murakawa, Hidekata Yasuoka, Shintaro Hirata, Hayato Nagasawa, Eiichi Tanaka, Nobuyuki Miyasaka, Hisashi Yamanaka, Kazuhiko Yamamoto, Isao Yokota, Tatsuya Atsumi, Tsutomu Takeuchi

Research output: Contribution to journalArticle

Abstract

Objectives: To identify predictive factors for remission by tocilizumab monotherapy in rheumatoid arthritis (RA) patients. Methods: This is a post hoc analysis of the SURPRISE study, a 2-year randomized, controlled study comparing the efficacy of tocilizumab with (ADD-ON) and without methotrexate (SWITCH). The primary endpoint was DAS28-ESR remission (<2.6) at week 24. The change in modified total Sharp score from baseline to week 52 (ΔmTSS/year) was also assessed as an endpoint. The effect of clinical parameters at baseline on remission was estimated by logistic regression analysis. Results: In SWITCH (n = 96), CRP, SAA, RF, and DAS28 at baseline showed predictive value for DAS28 remission in unadjusted analysis. Adjusted analysis confirmed SAA and DAS28 as predictive factors, with SAA having the highest value (ROC-AUC = 0.731). Furthermore, structural remission (ΔmTSS/year ≤ 0.5) rate was significantly higher in patients with SAA of < 50.0 μg/mL than other patients. In contrast, in ADD-ON (n = 98), only DAS28 showed predictive value for DAS28 remission. In patients with SAA < 50.0 μg/mL, both DAS28 remission and structural remission rate were comparable between SWITCH and ADD-ON. Conclusion: RA patients with low SAA levels at baseline may benefit similarly from tocilizumab with and without methotrexate. Trial registration number: NCT01120366.

Original languageEnglish
JournalModern Rheumatology
DOIs
Publication statusPublished - 2019 Jan 1

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Amyloid
Methotrexate
Serum
Rheumatoid Arthritis
Area Under Curve
Logistic Models
Regression Analysis
tocilizumab

Keywords

  • Monotherapy
  • prediction
  • remission
  • serum amyloid A
  • tocilizumab

ASJC Scopus subject areas

  • Rheumatology

Cite this

Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation : A post hoc analysis of the SURPRISE study. / Kato, Masaru; Kaneko, Yuko; Tanaka, Yoshiya; Inoo, Masayuki; Kobayashi-Haraoka, Hitomi; Amano, Koichi; Miyata, Masayuki; Murakawa, Yohko; Yasuoka, Hidekata; Hirata, Shintaro; Nagasawa, Hayato; Tanaka, Eiichi; Miyasaka, Nobuyuki; Yamanaka, Hisashi; Yamamoto, Kazuhiko; Yokota, Isao; Atsumi, Tatsuya; Takeuchi, Tsutomu.

In: Modern Rheumatology, 01.01.2019.

Research output: Contribution to journalArticle

Kato, M, Kaneko, Y, Tanaka, Y, Inoo, M, Kobayashi-Haraoka, H, Amano, K, Miyata, M, Murakawa, Y, Yasuoka, H, Hirata, S, Nagasawa, H, Tanaka, E, Miyasaka, N, Yamanaka, H, Yamamoto, K, Yokota, I, Atsumi, T & Takeuchi, T 2019, 'Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation: A post hoc analysis of the SURPRISE study', Modern Rheumatology. https://doi.org/10.1080/14397595.2019.1621026
Kato, Masaru ; Kaneko, Yuko ; Tanaka, Yoshiya ; Inoo, Masayuki ; Kobayashi-Haraoka, Hitomi ; Amano, Koichi ; Miyata, Masayuki ; Murakawa, Yohko ; Yasuoka, Hidekata ; Hirata, Shintaro ; Nagasawa, Hayato ; Tanaka, Eiichi ; Miyasaka, Nobuyuki ; Yamanaka, Hisashi ; Yamamoto, Kazuhiko ; Yokota, Isao ; Atsumi, Tatsuya ; Takeuchi, Tsutomu. / Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation : A post hoc analysis of the SURPRISE study. In: Modern Rheumatology. 2019.
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abstract = "Objectives: To identify predictive factors for remission by tocilizumab monotherapy in rheumatoid arthritis (RA) patients. Methods: This is a post hoc analysis of the SURPRISE study, a 2-year randomized, controlled study comparing the efficacy of tocilizumab with (ADD-ON) and without methotrexate (SWITCH). The primary endpoint was DAS28-ESR remission (<2.6) at week 24. The change in modified total Sharp score from baseline to week 52 (ΔmTSS/year) was also assessed as an endpoint. The effect of clinical parameters at baseline on remission was estimated by logistic regression analysis. Results: In SWITCH (n = 96), CRP, SAA, RF, and DAS28 at baseline showed predictive value for DAS28 remission in unadjusted analysis. Adjusted analysis confirmed SAA and DAS28 as predictive factors, with SAA having the highest value (ROC-AUC = 0.731). Furthermore, structural remission (ΔmTSS/year ≤ 0.5) rate was significantly higher in patients with SAA of < 50.0 μg/mL than other patients. In contrast, in ADD-ON (n = 98), only DAS28 showed predictive value for DAS28 remission. In patients with SAA < 50.0 μg/mL, both DAS28 remission and structural remission rate were comparable between SWITCH and ADD-ON. Conclusion: RA patients with low SAA levels at baseline may benefit similarly from tocilizumab with and without methotrexate. Trial registration number: NCT01120366.",
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T2 - A post hoc analysis of the SURPRISE study

AU - Kato, Masaru

AU - Kaneko, Yuko

AU - Tanaka, Yoshiya

AU - Inoo, Masayuki

AU - Kobayashi-Haraoka, Hitomi

AU - Amano, Koichi

AU - Miyata, Masayuki

AU - Murakawa, Yohko

AU - Yasuoka, Hidekata

AU - Hirata, Shintaro

AU - Nagasawa, Hayato

AU - Tanaka, Eiichi

AU - Miyasaka, Nobuyuki

AU - Yamanaka, Hisashi

AU - Yamamoto, Kazuhiko

AU - Yokota, Isao

AU - Atsumi, Tatsuya

AU - Takeuchi, Tsutomu

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: To identify predictive factors for remission by tocilizumab monotherapy in rheumatoid arthritis (RA) patients. Methods: This is a post hoc analysis of the SURPRISE study, a 2-year randomized, controlled study comparing the efficacy of tocilizumab with (ADD-ON) and without methotrexate (SWITCH). The primary endpoint was DAS28-ESR remission (<2.6) at week 24. The change in modified total Sharp score from baseline to week 52 (ΔmTSS/year) was also assessed as an endpoint. The effect of clinical parameters at baseline on remission was estimated by logistic regression analysis. Results: In SWITCH (n = 96), CRP, SAA, RF, and DAS28 at baseline showed predictive value for DAS28 remission in unadjusted analysis. Adjusted analysis confirmed SAA and DAS28 as predictive factors, with SAA having the highest value (ROC-AUC = 0.731). Furthermore, structural remission (ΔmTSS/year ≤ 0.5) rate was significantly higher in patients with SAA of < 50.0 μg/mL than other patients. In contrast, in ADD-ON (n = 98), only DAS28 showed predictive value for DAS28 remission. In patients with SAA < 50.0 μg/mL, both DAS28 remission and structural remission rate were comparable between SWITCH and ADD-ON. Conclusion: RA patients with low SAA levels at baseline may benefit similarly from tocilizumab with and without methotrexate. Trial registration number: NCT01120366.

AB - Objectives: To identify predictive factors for remission by tocilizumab monotherapy in rheumatoid arthritis (RA) patients. Methods: This is a post hoc analysis of the SURPRISE study, a 2-year randomized, controlled study comparing the efficacy of tocilizumab with (ADD-ON) and without methotrexate (SWITCH). The primary endpoint was DAS28-ESR remission (<2.6) at week 24. The change in modified total Sharp score from baseline to week 52 (ΔmTSS/year) was also assessed as an endpoint. The effect of clinical parameters at baseline on remission was estimated by logistic regression analysis. Results: In SWITCH (n = 96), CRP, SAA, RF, and DAS28 at baseline showed predictive value for DAS28 remission in unadjusted analysis. Adjusted analysis confirmed SAA and DAS28 as predictive factors, with SAA having the highest value (ROC-AUC = 0.731). Furthermore, structural remission (ΔmTSS/year ≤ 0.5) rate was significantly higher in patients with SAA of < 50.0 μg/mL than other patients. In contrast, in ADD-ON (n = 98), only DAS28 showed predictive value for DAS28 remission. In patients with SAA < 50.0 μg/mL, both DAS28 remission and structural remission rate were comparable between SWITCH and ADD-ON. Conclusion: RA patients with low SAA levels at baseline may benefit similarly from tocilizumab with and without methotrexate. Trial registration number: NCT01120366.

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