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In rheumatoid arthritis patients treated with tocilizumab, the rate of clinical disease activity index (CDAI) remission at 24 weeks is superior in those with higher titers of IgM-rheumatoid factor at baseline

  • Kawashiri, Shin-ya1
  • Kawakami, Atsushi1
  • Iwamoto, Naoki1
  • Fujikawa, Keita1
  • Aramaki, Toshiyuki1
  • Tamai, Mami1
  • Yamasaki, Satoshi1
  • Nakamura, Hideki1
  • Origuchi, Tomoki2
  • Ueki, Yukitaka3
  • Migita, Kiyoshi4
  • Mizokami, Akinari5
  • Aoyagi, Kiyoshi6
  • Eguchi, Katsumi1
  • 1 Nagasaki University, Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan , Nagasaki (Japan)
  • 2 Nagasaki University, Nagasaki University School of Health Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan , Nagasaki (Japan)
  • 3 Sasebo Chuo Hospital, Center for Rheumatic Disease, Sasebo, Japan , Sasebo (Japan)
  • 4 NHO National Nagasaki Medical Center, Department of General Internal Medicine, Nagasaki, Japan , Nagasaki (Japan)
  • 5 Nagasaki Municipal Hospital, Department of Internal Medicine, Nagasaki, Japan , Nagasaki (Japan)
  • 6 Nagasaki University Graduate School of Biomedical Sciences, Department of Public Health, Nagasaki, Japan , Nagasaki (Japan)
Published Article
Modern Rheumatology
Springer Japan
Publication Date
Jan 15, 2011
DOI: 10.1007/s10165-010-0409-0
Springer Nature


We aimed to evaluate the efficacy of tocilizumab in patients with rheumatoid arthritis (RA), using the clinical disease activity index (CDAI), and to determine the baseline variables associated with CDAI remission. Fifty-eight patients with active RA were enrolled. We tried to evaluate whether baseline variables were associated with CDAI remission at 24 weeks. Twenty-two of the 58 patients (37.9%) had received tumor necrosis factor (TNF) inhibitors. The continuation rate of tocilizumab at 24 weeks was 87.9%. The seropositivity rates of IgM-rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies at baseline were both 91.4%. The rate of CDAI remission at 24 weeks was 20.7%. We selected baseline variables including age, gender, duration of disease, concomitant use of glucocorticoids, concomitant use of methotrexate (MTX), previous anti-TNF therapy, titer of anti-CCP antibodies (high or low toward median), titer of IgM-RF (high or low toward median), and CDAI, and found that a high titer of IgM-RF was the only variable to be associated with CDAI remission, according to univariate and logistic regression analyses. This is a new finding, and may be specific to tocilizumab as compared with previous observations in anti-TNF therapy.

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