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

Autor:	Kato M; Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan., Kaneko Y; Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan., Tanaka Y; The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan., Inoo M; Department of Internal Medicine, Utazu Hospital, Ehime, Japan., Kobayashi-Haraoka H; Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan., Amano K; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan., Miyata M; Department of Internal Medicine, Fukushima Red Cross Hospital, Fukushima, Japan., Murakawa Y; Department of Rheumatology, Shimane University Faculty of Medicine, Izumo, Japan., Yasuoka H; Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan., Hirata S; Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan., Nagasawa H; Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan., Tanaka E; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan., Miyasaka N; Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Yamanaka H; Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan., Yamamoto K; Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Yokota I; Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo, Japan., Atsumi T; Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan., Takeuchi T; Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	Modern rheumatology [Mod Rheumatol] 2020 May; Vol. 30 (3), pp. 442-449. Date of Electronic Publication: 2019 Jun 07.
DOI:	10.1080/14397595.2019.1621026
Abstrakt:	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.
Databáze:	MEDLINE
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