ABSTRACT

Objective:

We planned to evaluate the response to treatment and safety data of patients who received Tocilizumab (TCZ) treatment with the diagnosis of rheumatoid arthritis in our clinic.

Methods:

Among the patients who were followed up until 2018 with the diagnosis of rheumatoid arthritis, those who received TCZ treatment were identified from our registry. All data were extracted retrospectively using the standard data table.

Results:

We identified 77 RA patients (57 females, 20 males), 25 of whom were juvenile-onset, who received TCZ treatment. The median number of conventional synthetic disease-modifying agent (cDMARD) use before TCZ treatment was 3 [interquartile range (IQR): 2-3.25, minimum-maximum: 1-4]. The number of biological DMARDs (bDMARDS) used per patient before TCZ was 3 (IQR: 2-4). 6 patients used TCZ as the first bDMARD. The median duration of Tocilizumab use was 13 months (IQR: 2-26.5). Twenty-three patients (30%) received TCZ as monotherapy. Forty (52%) of the patients were still under TCZ treatment. It was determined that the treatment of 37 patients (48%) was terminated in total, 20 patients (26%), primary non-response in 9 patients (12%), 5 patients’ requests (6%), and 3 patients (4%) due to side effects. It was observed that one patient who had a major infection died as a result of sepsis in the 7th month of treatment.

Conclusion:

Although TCZ is effective in treating rheumatoid arthritis, its use as monotherapy was low in our clinic. Low monotherapy rates may be due to the high number of cDMARD and biological DMARDs (bDMARDS) histories before TCZ regarding intractable disease activity. However, the rate of treatment continuity was sufficient. Liver enzyme elevations and infection were the main adverse effects in our experience.