|The following article is part of conference coverage from the 2018 American College of Rheumatology and Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago, Illinois. Rheumatology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in rheumatology. Check back for the latest news from ACR/ARHP 2018 .|
CHICAGO — Obesity and comorbidity burden have shown no association with efficacy of tocilizumab in improving disease activity of rheumatoid arthritis (RA). This research was recently presented at the 2018 ACR/ARHP Annual Meeting, held October 19-24, in Chicago, Illinois.
This study included 770 patients, 93.8% of whom received tocilizumab intravenously and 6.2% of whom were treated subcutaneously. Follow-up visits occurred at 6 and 12 months among patients in the Corrona RA registry. Outcomes were compared between patients with low vs high Charlson Comorbidity Index scores and low vs high BMI. Mean change at 6 and 12 months in Crohn disease activity index was the primary outcome, while the number of patients with significant change in Crohn disease activity index and health assessment questionnaire, the number whose disease activity improved to low, and the change in health assessment questionnaire score comprised secondary outcomes.
Standardized differences were utilized to compare clinical features, baseline demographic information, disease activity, and history of treatment among the cohorts, with standardized differences less than 0.1 classified as covariates.
The Charlson Comorbidity Index was high among 25.3% of participants. Patients with high comorbidity burden tended to be older (61.5 vs 56.9 years), had a longer disease course (12.8 vs 11.6 years), had higher baseline Crohn disease activity index (25.7 vs 23.9) and health assessment questionnaire (0.71 vs 0.57) scores, and were more likely obese (52.8% vs 41.7%).
At baseline, 44.2% of those treated with tocilizumab were obese. Patients with obesity were younger (56.7 vs 59.0 years), had shorter disease duration (11.4 vs 12.6 years), and had higher baseline Crohn’s disease activity index (25.4 vs 23.6) and health assessment questionnaire (0.65 vs 0.57) scores. Baseline Crohn disease activity index scores improved across all cohorts at the 6-month and 12-month marks.
The study researchers conclude that “the effectiveness of [tocilizumab] for the improvement of RA disease activity was comparable among patients regardless of comorbidity burden or obesity.”
All authors report associations with pharmaceutical companies, including Novartis, Corrona, and Genentech. For a full list of author disclosures, please see abstract.
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Pappas DA, Etzel CJ, Crabtree M, Best JH, Zlotnick S, Kremer J. Impact of comorbidity burden and obesity on the effectiveness of tocilizumab in patients with rheumatoid arthritis. Presented at: 2018 ACR/ARHP Annual Meeting; October 19-24, 2018; Chicago, IL. Abstract 1514.
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