RA: Low Disease Activity Maintained With Methotrexate After Tocilizumab Discontinuation

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Tocilizumab discontinuation after remission achievement is feasible for maintaining low disease activity with continued methotrexate.
Tocilizumab discontinuation after remission achievement is feasible for maintaining low disease activity with continued methotrexate.

In patients with rheumatoid arthritis (RA) who achieve remission with tocilizumab, low disease activity can be sustained with methotrexate after tocilizumab discontinuation, according to results published in the Annals of the Rheumatic Diseases.

The study included participants from the SURPRISE study (ClinicalTrials identifier: NCT01120366) who had been randomly assigned to additional tocilizumab or to switch to tocilizumab in the first year who had reached RA remission at 52 weeks and then discontinued tocilizumab (n=105). Participants were then followed for an additional 52 weeks.

During the follow-up period, participants who received tocilizumab as additional therapy continued methotrexate and participants who switched to tocilizumab received no disease-modifying antirheumatic drugs.

In participants who received tocilizumab as additional therapy, sustained Disease Activity Score for 28 joints (DAS28) low disease-activity rates were significantly higher compared with participants who switched to tocilizumab (55% vs 27%; P =.005). At 104 weeks, sustained remission rates were 24% in participants who received tocilizumab as additional therapy and 14% in participants who switched to tocilizumab (P =.29).

In addition, radiologic progression measured by the modified total Sharp score was similar in participants who received tocilizumab as additional therapy compared with participants who switched to tocilizumab (0.37 vs 0.67; P =.36).

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Reference

Kaneko Y, Kato M, Tanaka Y, et al. Tocilizumab discontinuation after attaining remission in patients with rheumatoid arthritis who were treated with tocilizumab alone or in combination with methotrexate: results from a prospective randomised controlled study (the second year of the SURPRISE study) [published online May 31, 2018]. Ann Rheum Dis. doi:10.1136/ annrheumdis-2018-213416S

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