Efficacy of tocilizumab and evaluation of clinical remission as determined by CDAI and MMP-3 level
| Autor: | Satoru Koyano, Kosuke Okuda, Takafumi Hagiwara, Tsukasa Matsubara, Keiko Funahashi, Takako Miura |
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| Rok vydání: | 2009 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty Arthritis Blood Sedimentation Antibodies Monoclonal Humanized Gastroenterology Severity of Illness Index Arthritis Rheumatoid chemistry.chemical_compound Tocilizumab Rheumatology Internal medicine Severity of illness medicine Humans skin and connective tissue diseases medicine.diagnostic_test business.industry Interleukin-6 Remission Induction Antibodies Monoclonal Middle Aged medicine.disease Clinical disease Treatment Outcome chemistry Rheumatoid arthritis Erythrocyte sedimentation rate Antirheumatic Agents Monoclonal Immunology Female Matrix Metalloproteinase 3 business |
| Zdroj: | Modern rheumatology. 19(5) |
| ISSN: | 1439-7609 |
| Popis: | Tocilizumab, a biological agent developed in Japan, is a human anti-interleukin-6 (anti-IL-6) receptor antibody. Rheumatoid arthritis improves with its use. A remission rate of 59% is attainable, as measured by disease activity score 28 (DAS28) in the SAMURAI study. However, in tocilizumab treatment, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels drop to negative values; therefore we sought to utilize a different index for measuring its efficacy. In order to evaluate the effects of tocilizumab we carried out this study using clinical disease activity index (CDAI), as it is not reliant on blood data and would also allow us to determine which markers are present in remission. Twenty-two patients under treatment with tocilizumab participated in this study. Effects of treatment as well as the remission rate were measured by CDAI and DAS28 3 months after initiation of treatment. IL-6 and matrix metalloproteinase-3 (MMP-3) levels were measured at the same time. We studied the clinical efficacy of tocilizumab using DAS28 after treatment; remission as measured by DAS28 was 57.1% at 1 year. However, the remission rate as measured by CDAI was only 19.1% at 1 year. CDAI was not only correlated with DAS28, but also other clinical variables, MMP-3, and IL-6. We conclude that CDAI is effective in measuring clinical response to tocilizumab treatment, and that MMP-3 level is as useful as IL-6 level as an indicator. |
| Databáze: | OpenAIRE |
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