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Volume 52, Number 1, February 2019

Safety and effectiveness of tocilizumab in treating patients with rheumatoid arthritis – A three-year study in Taiwan 


Ching-Tsai Lin, Wen-Nan Huang, Chia-Wei Hsieh, Yi-Ming Chen, Der-Yuan Chen, Tsu-Yi Hsieh, Yi-Hsing Chen


 

Background and purpose: 

To evaluate the long-term safety and effectiveness of tocilizumab (TCZ) for the treatment of rheumatoid arthritis (RA) in a real-world clinical setting in Taiwan.

 



 

Methods:

All refractory RA patients who initiated intravenous TCZ between August 2012 and March 2015 were enrolled. Data on patient characteristics, drug safety and effectiveness were collected.

 



 

Results:

A total of 114 RA patients were recruited. Despite the majority of them (93%) had previous biologic failure, 43.75% of the patients were able to reach ACR50 after one year. Serious adverse events commonly found were bacterial pneumonia (4.24/100 patient-years) followed by cellulitis (2.12/100 patient-years). Twenty-three patients had old or latent TB infections, 11 patients had chronic hepatitis B. During the 3 years follow-up, none of them had reactivation of TB, or hepatitis B with concomitant use of isoniazid prophylaxis or pre-emptive antiviral treatment. 



 

Conclusion:

In this 3-year real-world study on RA patients of Taiwan, we found a good long-term effectiveness and similar safety profiles for the TCZ treatment. With prophylactic strategy for latent TB and pre-emptive antiviral treatment for HBV carriers, the risk of reactivation of latent TB and HBV may be reassured. 



 

Key words:

Hepatitis BRheumatoid arthritisSafety and effectivenessTocilizumabTuberculosis