THU0206 Add-on short-course tocilizumab accelerates dose tapering of glucocorticoids in rheumatoid arthritis: results from a chinese prospective cohort study

ANNALS OF THE RHEUMATIC DISEASES(2018)

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摘要
Background In real-world clinical practice, self-paid and expensive price limit the application of bDMARDs and only a few patients especially in developing countries could afford long-term use. Only 9.1%>11% of Chinese rheumatoid arthritis (RA) patients were treated with bDMARDs with mean course no more than 6 months. Such short course of bDMARDs had always been raised doubt about their efficacy and benefit for rare reported evidence. Objectives To explore the efficacy of additional short-course of Tocilizumab (TCZ) combined with csDMARDs in real-world RA management. Methods Consecutive patients with active RA (DAS28-ESR>2.6) who had completed 6 month follow-up were retrospectively recruited from a prospective RA cohort (n=582). All patients were treated according to the treat-to-target strategy and patient’s willingness especially biologics use. RA patients who finished at least 3 infusions of TCZ (8 mg/Kg/4 weeks) were included as add-on TCZ group, and matched RA patients without any bDMARDs by age, sex and disease activity at baseline with the ratio of 1:1 were included as csDMARDs group. Clinical data were collected according to the 2017 EULAR recommendation at baseline and regular visits at week 4, 12 and 24. Results (1) The baseline characteristics of 101 paired RA patients showed no significant difference except for lower csDMARDs-naive percentage between two groups (table 1). (2) During 24 week follow up, there were significantly higher percentage of patients in add-on TCZ group achieving therapeutic target (DAS28-ESR Conclusions Add-on short-course TCZ may be an alternative induction strategy for RA patients in developing countries which can quickly achieve target and accelerate dose tapering of GC. Acknowledgements This work was supported by National Natural Science Foundation of China (grant no. 81471597, 81671612 and 8160147) and Guangdong Natural Science Foundation (grant no. 2016A030313307 and 2017A030313576). Disclosure of Interest None declared
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