Dataset Information

Successful long-term remission through tapering tocilizumab infusions: a single-center prospective study.

ABSTRACT:

Background

Strategic drug therapy for rheumatoid arthritis (RA) patients with prolonged remission is not well defined. According to recent guidelines, tapering biological Disease-Modifying Anti-Rheumatic Drugs (bDMARDs) may be considered. We aimed to evaluate the effectiveness of long-term maintenance of tocilizumab (TCZ) treatment after the progressive tapering of infusions.

Methods

We conducted an exploratory, prospective, single-center, open-label study, on RA patients with sustained remission of at least 3 months and treated with TCZ infusions every 4 weeks. The initial re-treatment interval was extended to 6 weeks for the first 3 months. Thereafter, the spacing between infusions was determined by the clinician. Successful long-term maintenance following the tapering of TCZ infusions was defined by patients still treated after two years by TCZ with a minimum dosing interval of 5 weeks.

Results

Thirteen patients were enrolled in the study. Eight out of thirteen were still treated by TCZ after two years. Successful long-term maintenance was possible in six patients, with four patients maintaining a re-treatment interval of 8-weeks or more. We observed 5 patients with TCZ withdrawal: one showing adverse drug reaction (neutropenia) and four with secondary failure. Patients achieving successful long-term maintenance with TCZ were significantly younger than those with secondary failure (p < 0.05). In addition, RA patients with positive rheumatoid factor and anti-citrullinated peptide antibodies, experienced a significantly greater number of flares during our 2-year follow-up (p < 0.01).

Conclusions

A progressive tapering of TCZ infusions may be possible for many patients. However, larger studies, including more patients, are needed to confirm this therapeutic option.

Trial registration

NCT02909998. Date of registration: October 2008.

SUBMITTER: Ladhari C

PROVIDER: S-EPMC7047400 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Successful long-term remission through tapering tocilizumab infusions: a single-center prospective study.

Ladhari Chayma C Le Blay Pierre P Vincent Thierry T Larbi Ahmed A Rubenstein Emma E Lopez Rosanna Ferreira RF Jorgensen Christian C Pers Yves-Marie YM

BMC rheumatology 20200228

<h4>Background</h4>Strategic drug therapy for rheumatoid arthritis (RA) patients with prolonged remission is not well defined. According to recent guidelines, tapering biological Disease-Modifying Anti-Rheumatic Drugs (bDMARDs) may be considered. We aimed to evaluate the effectiveness of long-term maintenance of tocilizumab (TCZ) treatment after the progressive tapering of infusions.<h4>Methods</h4>We conducted an exploratory, prospective, single-center, open-label study, on RA patients with sus ...[more]

PMID: 32161846

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Dataset Information

Successful long-term remission through tapering tocilizumab infusions: a single-center prospective study.

Background

Methods

Results

Conclusions

Trial registration

Publications

Successful long-term remission through tapering tocilizumab infusions: a single-center prospective study.

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