Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation: A post hoc analysis of the SURPRISE study.
Mod Rheumatol
; 30(3): 442-449, 2020 May.
Article
em En
| MEDLINE
| ID: mdl-31106666
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
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Proteína Amiloide A Sérica
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Metotrexato
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Antirreumáticos
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Anticorpos Monoclonais Humanizados
Tipo de estudo:
Clinical_trials
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Mod Rheumatol
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Japão