Successful long-term remission through tapering tocilizumab infusions: a single-center prospective study.
Maintenance
Remission
Rheumatoid arthritis
Tapering
Tocilizumab
Journal
BMC rheumatology
ISSN: 2520-1026
Titre abrégé: BMC Rheumatol
Pays: England
ID NLM: 101738571
Informations de publication
Date de publication:
2020
2020
Historique:
received:
26
07
2019
accepted:
10
12
2019
entrez:
13
3
2020
pubmed:
13
3
2020
medline:
13
3
2020
Statut:
epublish
Résumé
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. 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. Thirteen patients were enrolled in the study 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. NCT02909998. Date of registration: October 2008.
Sections du résumé
BACKGROUND
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
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
RESULTS
Thirteen patients were enrolled in the study
CONCLUSIONS
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
BACKGROUND
NCT02909998. Date of registration: October 2008.
Identifiants
pubmed: 32161846
doi: 10.1186/s41927-019-0109-0
pii: 109
pmc: PMC7047400
doi:
Banques de données
ClinicalTrials.gov
['NCT02909998']
Types de publication
Journal Article
Langues
eng
Pagination
5Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Competing interestsYves-Marie PERS is a member of the editorial board of BMC Rheumatology. All the remaining authors declare that they have no competing interests.
Références
J Rheumatol. 2015 Nov;42(11):2012-22
pubmed: 26428204
Arthritis Rheum. 2009 Aug;60(8):2262-71
pubmed: 19644846
Ann Rheum Dis. 2009 Jun;68(6):914-21
pubmed: 18662933
Rheumatol Int. 2017 Nov;37(11):1789-1798
pubmed: 28852832
Ann Rheum Dis. 2012 Nov;71(11):1849-54
pubmed: 22504561
Rheumatol Int. 2018 Dec;38(12):2307-2313
pubmed: 30206670
Ann Rheum Dis. 2015 Jan;74(1):35-43
pubmed: 25169728
J Rheumatol. 2013 Jul;40(7):1069-73
pubmed: 23729804
RMD Open. 2016 Jan 14;2(1):e000133
pubmed: 26819752
Clin Exp Rheumatol. 2017 Jul-Aug;35(4):666-670
pubmed: 28229812
Ann Rheum Dis. 2017 Jun;76(6):960-977
pubmed: 28264816
Ann Rheum Dis. 2015 May;74(5):843-50
pubmed: 24431394
Ann Rheum Dis. 2016 Jan;75(1):59-67
pubmed: 26103979
Ann Rheum Dis. 2014 Mar;73(3):492-509
pubmed: 24161836
Ther Adv Musculoskelet Dis. 2016 Aug;8(4):107-18
pubmed: 27493689
Lancet. 2013 Mar 16;381(9870):918-29
pubmed: 23332236
Ann Rheum Dis. 2010 Jul;69(7):1286-91
pubmed: 20360136
Mod Rheumatol. 2014 Jan;24(1):17-25
pubmed: 24261754
Ann Rheum Dis. 2007 Jan;66(1):34-45
pubmed: 16396980
Semin Arthritis Rheum. 2005 Apr;34(5 Suppl1):12-8
pubmed: 15852249
Clin Exp Rheumatol. 2005 Sep-Oct;23(5 Suppl 39):S100-8
pubmed: 16273793
Mod Rheumatol. 2018 May;28(3):444-451
pubmed: 28849709
Best Pract Res Clin Rheumatol. 2011 Aug;25(4):607-24
pubmed: 22137927
Ann Rheum Dis. 2019 Jun;78(6):746-753
pubmed: 30954969
Ann Rheum Dis. 2016 Jan;75(1):52-8
pubmed: 25873634
Rheumatol Adv Pract. 2018 Apr 12;2(1):rky008
pubmed: 31431957
Ann Rheum Dis. 2010 Sep;69(9):1636-42
pubmed: 20421345
Arthritis Rheum. 1995 Jan;38(1):44-8
pubmed: 7818570