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Motohiko Aizu, Ichiro Mizushima, Satoshi Nakazaki, Akikatsu Nakashima, Takashi Kato, Takashi Murayama, Shinichi Kato, Yasuo Katsuki, Kunihiro Ogane, Hiroshi Fujii, Kazunori Yamada, Hideki Nomura, Akihiro Yachie, Masakazu Yamagishi, Mitsuhiro Kawano, Changes in serum interleukin-6 levels as possible predictor of efficacy of tocilizumab treatment in rheumatoid arthritis, Modern Rheumatology, Volume 28, Issue 4, 4 July 2018, Pages 592–598, https://doi.org/10.1080/14397595.2017.1370766
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Abstract
Objectives: We aimed to evaluate the association between the change in serum IL-6 during the clinical course of tocilizumab (TCZ) therapy and rheumatoid arthritis (RA) disease activity or occurrence of adverse events.
Methods: General laboratory data including serum IL-6 levels and physical findings were obtained every 4 weeks, and, in addition, at the time when any adverse events occurred.
Results: The proportion achieving Clinical Disease Activity Index (CDAI) remission at 52 weeks was significantly lower in 20 patients with serum IL-6 ≥ 30 pg/ml at 12 weeks than 24 patients with serum IL-6 < 30 pg/ml. In 17 patients with serum IL-6 ≥ 30 pg/ml at 24 weeks, the proportion achieving CDAI remission was also significantly lower than 27 patients with serum IL-6 < 30 pg/ml then. In these 17 patients, Disease Activity Score (DAS) 28-ESR and CDAI at 52 weeks were significantly higher than those with serum IL-6 < 30 pg/ml. Age- and sex-adjusted logistic regression analysis showed logIL-6 at 12 weeks to be a predictive factor for DAS28-ESR remission at 52 weeks.
Conclusion: Serum IL-6 levels from 12 to 24 weeks after TCZ initiation better reflect the efficacy of TCZ at 52 weeks.