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Workshop Improved Significantly During TCZ Therapy Workshop improved significantly during TCZ therapy. CONCLUSION: TCZ W1-1 has shown high efficacy in RA as the first biologics. HAQ short-term improvement in patients administered tocilizu- mab in our hospital Keio Ayabe, Takumi Wakisaka, Muneo Aoyagi, Hiromi Kameda, W1-4 Keiko Sonobe, Sachiko Itoi A retrospective study of tocilizumab therapy in rheumatoid ar- Keiyu Orthopedic Hospital, Gunma, Japan thritis Hiroshi Tanaka, Mamoru Kanazawa, Toshifumi Kawakami, Kenji Objective: HAQ improvement was investigated in rheumatoid Kido, Makoto Kubo, Yasuhiro Tamimoto, Takeshi Tokito, Atsunori arthritis (RA) patients administered tocilizumab (TCZ) from March Tokushige, Kimio Nibu, Noriyuki Miyazaki, Hajime Miyazato, to October 2010 and observed for at least 24 weeks. Subjects and Kenji Yamamoto, Manabu Yamamoto, Toshiko Watada, Shinji Method: 8 RA patients included 1 in stage I, 1 in stage II, 4 in stage Fukuta, Toshihiko Taguchi III and 2 in stage IV; and 2 in Class 1, 3 in Class 2 and 4 in Class 3. Yamaguchi IL-6 Meeting Mean age was 64.7 and disease duration was 7 years. 4 patients switched from other biological agents. Results: HAQ improved Objective: To study the efficacy/safety of tocilizumab (TCZ) in from 1.8 (0.6–2.5) before TCZ administration to 1.4 (0–1.9) at 12 rheumatoid arthritis patients. Subjects and methods: The subjects weeks and 1.3 (0–1.9) at 24 weeks of administration. In addition to were 46 patients who could be observed for at least 48 weeks, who HAQ, overall improvements were also seen in DAS28-ESR and had a mean age of 61.0 years, a mean duration of illness of 10.1 MMP-3 and the subjects showed no particular side effects. Conclu- years, and a DAS28-ESR of 5.1 ± 1.4, and 63% of whom had been sion: TCZ was found to be a useful drug for short-term improve- treated with TNF inhibitors in the past. Results: After 48 weeks, the ment of HAQ in RA patients. proportion of patients exhibiting remission was 58.7%. Of the 21 pa- tients (45.7%) who exhibited remission at 12 weeks, 90.5% were still in remission after 48 weeks. The proportion of patients continu- W1-2 ing treatment at 48 weeks was 82.6%. Four serious adverse events Evaluation of the injection interval of Tocilizumab after in RA (in four patients) were seen. Conclusions: The results suggested that patients TCZ therapy allows patients to stay in remission over the long term. Kaori Yokota1, Taio Naniwa2, Kaneshige Sasaki2 1Tajimi Hospital, Tajimi, Japan, 2Nagoya City University School of Medical Sciences Department of Medical Oncology and Immunolo- W1-5 gy Influence of age in RA patients treated with Tocilizumab from TBC Registry 1 2 3 4 Objective:To report on the RA patients who extended the injec- Nobuyuki Asai , Atsushi Kaneko , Hisato Ishikawa , Seiji Tsuboi , 5 2 4 tion interval of Tocilizumab (TCZ) after a clinical remission. Meth- Yuichiro Yabe , Kiwamu Saito , Tomone Shioura , Tomonori 6 7 7 ods: 36 patients were treated with TCZ, and background and the Kobayakawa , Toshihisa Kojima , Naoki Ishiguro 1 clinical course on the patients who were able to have the injection Nakatsugawa Municipal General Hospital, Nakatsugawa, Japan, 2 3 interval extended. Results:The injection intervals of 13 patients were Nagoya Medical Center, Nagoya, Japan, Nagano Red Cross Hospi- 4 extended up to a maximum every eight weeks. The concomitant tal, Nagano, Japan, Shizuoka Kousei Hospital, Shizuoka, Japan, 5 6 PSL dosage was significantly low in these patients. Three patients Tokyo KoseiNenkin Hospital, Tokyo, Japan, Toyohashi Municipal 7 returned every four weeks, and had a significantly longer disease Hospital, Toyohashi, Japan, Nagoya University, Nagoya, Japan duration and low MMP-3 before TCZ treatment. Conclusion: Even if the TCZ treatment the injection interval is extended after a clinical Objective: The influence of the age on the effectiveness of TCZ remission, it can be maintained. However, it was thought that atten- is investigated by using the TBC registry. Methods: 123 patients tion was necessary for the disease duration. treated with TCZ were divided into two groups (L and H) in the me- dian age. Effectiveness was evaluated as DAS28-ESR every six months. Results: H group was significantly the disease duration was W1-3 long, CLASS progressed, and rate of concomitant MTX was low in Efficacy of tocilizumab as the first biologics for rheumatoid ar- baseline characteristics. In DAS measurement, L group was 5.9, 2.9, thritis patients and 2.8, and H group was 5.7, 3.4, and 3.2 at baseline, 6 months and Masao Sato1, Masao Takemura2, Ryuki Shinohe3, Katsuji Shimizu1 12 months, and a significant difference was seen between groups at 1Department of Orthopaedic Surgery, Gifu University School of six months. In the remission rate, L group was 44.7% and 42.9%, Medicine, Gifu, Japan, 2Department of Informative Laboratory Med- and H group was 31.7% and 43.3% at 6 months and 12 months. icine, Gifu University School of Medicine, Gifu, Japan, 3Department Conclusion: It has been understood to require time by the remission of Orthopaedic Surgery, Nishimino Welfare Hospital, Gifu, Japan in H group. OBJECTIVES: The aim of this study is to evaluate the efficacy of tocilizumab (TCZ) as the first biologics for patients with rheuma- W1-6 toid arthritis (RA). METHODS: The study population comprised 41 Minimum two years results of Tocilizumab for Patients with RA patients (8 men, 33 women). The mean age of the patients was Rheumatoid Arthritis 1 1 1 59 years (range 22-76 years). The patients were administered TCZ Yasuharu Nakashima , Masakazu Kondo , Takashi Ishinishi , 1 1 1 1 (8 mg/kg) every 4 weeks and evaluated by DAS 28. RESULTS: The Takeshi Otsuka , Koji Kuroda , Hiroshi Jojima , Eisuke Shono , 1 1 1 disease activity score (DAS) 28 at the baseline and at the evaluated Eiichi Suematsu , Tomomi Tsuru , Hitoshi Nakashima , Ryuji 1 1 1 endpoint were 6.87 and 2.49, respectively. The DAS 28 decreased Nagamine , Hiroshi Harada , Takahiko Horiuchi , Hisaaki 1 1 2 significantly from baseline to at evaluated endpoint (p<0.0001). Miyahara , Ken Wada , Yukihide Iwamoto With or without the usage of MTX, clinical symptoms and DAS 28 S43 1Fukuoka RA Biologics treatment Study Group, 2Department of Or- efficacy of TCZ for RA by analyzing gene expression in PBMC be- thopaedic Surgery, Kyushu University fore therapy by using DNA array. We retrospectively observed the clinical efficacy of tocilizumab (TCZ) in 77 patients with RA at 13 hospitals, without any restric- W2-3 tions on disease duration or stage, treatment history, etc. Disease ac- Effect of tocilizumab (TCZ) on serum lipid in patients with tivity was evaluated every 4 weeks for minimum 2 years using rheumatoid arthritis DAS28. Remission and treatment response were categorised using Kentaro Hanami, Saito Kazuyoshi, Masao Nawata, Naoki Yunoue, EULAR definitions. We also analysed the impact of previous treat- Ippei Miyagawa, Yoshiya Tanaka ment with other biologics and of concomitant methotrexate (MTX) The First Department of Internal Medicine, University of Occupa- on the efficacy of TCZ.At 2 years, DAS28 had improved to 2.4 and tional and Environmental Health, Japan, Kitakyushu, Japan the EULAR remission rate was 66.1%. The biologic-naïve group had a significantly better DAS28 (1.9 versus 2.6) and a significantly 54 patients (pts) on TCZ and 20 pts with MTX as control group higher remission rate (81% versus 60%) than the biologic-exposed were analyzed at 0, 24 wks with DAS28 and biological markers in- group. Concomitant MTX did not show the significant effects cluding HMW-AN. DAS28 of the 54 pts reduced after 24 wks of through the periods. We conclude that TCZ significantly alleviated TCZ. Although TC, HDL-C, LDL-C and remnant like particles in- the symptoms in a wide range of patients with RA in normal clinical creased by TCZ, atherogenic index did not affected and remained in practice. the normal range. Those changes were also observed in MTX group. In addition HMW-AN significantly increased. Changes of HMW- AN were not related to DAS28 at baseline, changes of DAS28 at 24 W2-1 wks, the corticosteroid dose, with or without concomitant MTX and A treatment for a patient CRP rose 4weeks after the first Tocili- prior use of biologics. This change was higher in pts switching to zumab infusion TCZ than another TNF inhibitors from infliximab. This results was Naohiko Gunji, Takashi Kanno suggesting action of TCZ for lipid metabolism could be independent Ohta Nishinouchi Hospital, Department of Rheumatology, Fukushi- on inflammation in synovitis. ma, Japan Background : Time required for tocilizumab (TCZ) to show ef- W2-4 fect varies among rheumatoid arthritis (RA) cases. Methods/results : The validity of activity evaluation in rheumatoid arthritis with A 62 y.o. male had stageⅠclass 2 RA for 1 y (disease onset Jan09) tocilizumab with no other medical history. Adalimumab was started in Nov09 Satoshi Nakazaki1, Takashi Murayama1, Shinichi Kato2 but was ineffective and replaced with TCZ in Jan10. CRP (mg/dL) 1Department of Rheumatology, Johoku Hospital, 2Department of and DAS28-ESR4 (DAS28) were 7.2 and 8.7, which rose to 13.5 Rheumatology, Kamiaraya Clinic and 8.7 after 4 wk of TCZ. Blood TCZ levels were inadequate and the interval was adjusted to 3 wk. CRP was negative and DAS28 We investigated the validity of activity evaluation method in RA was 4.5 after 10 wk. He remitted after 14 wk (negative CRP; patients with tocilizumab (TCZ). By reduced rate of ESR, DAS28: 1.2). No adverse events occurred. Conclusion : In highly DAS28(ESR) and CDAI, 65 RA patients with TCZ and 43 RA pa- active TCZ-treated RA cases with high CRP 4 wk after initiating tients with adalimumab (ADA) were analyzed.
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