AB0409 Corticosteroid-sparing in patients with rheumatoid arthritis on tocilizumab: first experience of bab -el- oued hospital

Abstract

Background: Tocilizumab (TCZ) is a monoclonal antibody directed against the IL‐6 receptors. This treatment (TRT) allows for the cortisone weaning in preventing of its complications. Objectives: The goal of this study is to evaluate the corticosteroid sparing in patients with RA treated with TCZ. Methods: Prospective, descriptive study of patients hospitalized between 2012 and 2016, the diagnosis was made according to the ACR 1987 ACR/EULAR 2010 criteria. Included, are the patients treated with TCZ for at least 3 months associated with corticosteroids. We have studied the following: the epidemiology, the associated DMARDs, the average DAS28VS, the average dosage of prednisone‐equivalent and the percentage of patients with decreased or interrupted corticosteroids at M0, M3, M6 and M12. Results: 26 patients (sex ratio: 0.7) treated with TCZ and corticosteroids, average age is 43.4 years (range 30‐62). Average duration of the development of RA: 9.1±6.4 years. DMARDs was associated in 15 patient. At baseline, 46.2% of patients were on 10 mg/day of cortisone, the average dose of prednisone‐equivalent was at 7.7±3.6mg at M0, 5.3±3.2 mg at M3, 4.6±2.3 mg at M6, 2.6±2.6 mg at M12 with a statistically significant difference (p=0.000003). The average DASVS28 activity index was 5.6±0.9 at M0, 3.5±1.3 at M3, 3.04±1.2 at M6 and 2.6 ± M6 at M12 with a statistically significant difference (p<0.000001). Corticosteroid treatment was stopped in 12 patients after 1 year of treatment. Conclusions: Through this study we note that the TRT using TCZ has enabled a significant reduction in the dose of corticosteroids. Stopping prednisone was possible in 50% of patients after 1 year of biotherapy.