Successful long-term remission through tapering tocilizumab infusions: a single-center prospective study

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 tocil...

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Bibliographic Details
Published in:BMC rheumatology 2020-02, Vol.4 (1), p.5-5, Article 5
Main Authors: Ladhari, Chayma, Le Blay, Pierre, Vincent, Thierry, Larbi, Ahmed, Rubenstein, Emma, Lopez, Rosanna Ferreira, Jorgensen, Christian, Pers, Yves-Marie
Format: Article
Language:English
Subjects:
Antibodies
Arthritis
Biological products
Disease
Drug dosages
Immunosuppressive agents
Life Sciences
Maintenance
Monoclonal antibodies
Patients
Peptides
Remission
Rheumatoid arthritis
Standard deviation
Tapering
Tocilizumab
Tumor necrosis factor-TNF
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Summary: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 Eight out of thirteen were still treated by TCZ after two years Successful long-term maintenance was possible in six patients, with four patients maintaining a re-treatment interval of 8-weeks or more. We observed 5 patients with TCZ withdrawal: one showing adverse drug reaction (neutropenia) and four with secondary failure. Patients achieving successful long-term maintenance with TCZ were significantly younger than those with secondary failure (  
ISSN:2520-1026
2520-1026
DOI:10.1186/s41927-019-0109-0