PMID- 31359057
OWN - NLM
STAT- MEDLINE
DCOM- 20200821
LR  - 20200821
IS  - 1462-0332 (Electronic)
IS  - 1462-0324 (Linking)
VI  - 59
IP  - 4
DP  - 2020 Apr 1
TI  - Efficacy and safety of tocilizumab in a real-life observational cohort of 
      patients with polyarticular juvenile idiopathic arthritis.
PG  - 732-741
LID - 10.1093/rheumatology/kez291 [doi]
AB  - OBJECTIVES: To evaluate the patterns of usage, efficacy and safety of tocilizumab 
      in polyarticular JIA. METHODS: An observational study of 56 consecutive 
      polyarticular JIA patients was conducted using patient charts and electronic JIA 
      databases. Efficacy was assessed by tocilizumab survival, rates of low disease 
      activity (LDA) and of inactive disease by 10-joint Juvenile Arthritis Disease 
      Activity Score (JADAS-10), and of clinically inactive disease according to 
      Wallace's preliminary criteria. Efficacy and rate of adverse events (AEs) were 
      evaluated during a 24-month period after tocilizumab commencement. RESULTS: 
      Tocilizumab was started on average as third-line biological agent (median, range 
      first- to fourth-line) at a median disease duration of 5.2 years (interquartile 
      range 3.0-7.7). Survival rates were 82% at 12 months and 64% at 24 months. The 
      reasons for discontinuation were inadequate treatment effect in 50%, AE plus 
      inadequate treatment effect in 37.5% and AE alone in 12.5%. LDA (JADAS-10 ⩽3.9) 
      was reached in 58% at 12 months and in 84% at 24 months, inactive disease 
      (JADAS-10 ⩽0.7) in 19% and 44%, and clinically inactive disease in 28% and 46%, 
      respectively. The rate of AEs was 200.9/100 patient years and of serious AEs 
      12.9/100 patient years. CONCLUSION: Survival of tocilizumab was high and a large 
      proportion of the treatment-resistant patients reached LDA at 12 months of 
      treatment. The LDA rate continued to increase throughout 24 months. The rates of 
      AEs and serious AEs were higher than in register studies but lower than in the 
      originator study of tocilizumab.
CI  - (c) The Author(s) 2019. Published by Oxford University Press on behalf of the 
      British Society for Rheumatology. All rights reserved. For permissions, please 
      email: journals.permissions@oup.com.
FAU - Gronlund, Minna-Maija
AU  - Gronlund MM
AD  - Department of Pediatrics, Turku University Hospital, Turku.
FAU - Remes-Pakarinen, Terhi
AU  - Remes-Pakarinen T
AD  - Department of Pediatrics, Kuopio University Hospital, Kuopio.
FAU - Kroger, Liisa
AU  - Kroger L
AD  - Department of Pediatrics, Kuopio University Hospital, Kuopio.
FAU - Markula-Patjas, Kati
AU  - Markula-Patjas K
AD  - Department of Paediatrics, Tampere University Hospital, Tampere.
AD  - University of Tampere, Tampere.
FAU - Backstrom, Maria
AU  - Backstrom M
AD  - Department of Pediatrics, Vaasa Central Hospital, Vaasa.
FAU - Putto-Laurila, Anne
AU  - Putto-Laurila A
AD  - Department of Pediatrics, Turku University Hospital, Turku.
FAU - Aalto, Kristiina
AU  - Aalto K
AD  - Department of Children and Adolescents, Helsinki University Hospital, Helsinki.
AD  - Pediatric Research Center, University of Helsinki, Helsinki.
FAU - Vahasalo, Paula
AU  - Vahasalo P
AD  - Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 
      Oulu.
AD  - Department of Children and Adolescents, Oulu University Hospital, Oulu.
AD  - PEDEGO Research Unit, University of Oulu, Oulu, Finland.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Rheumatology (Oxford)
JT  - Rheumatology (Oxford, England)
JID - 100883501
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Glucocorticoids)
RN  - 0 (Tumor Necrosis Factor Inhibitors)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - EC 2.6.1.2 (Alanine Transaminase)
RN  - G162GK9U4W (Leflunomide)
RN  - I031V2H011 (tocilizumab)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
CIN - Rheumatology (Oxford). 2020 Apr 1;59(4):707-708. PMID: 31998946
MH  - Adolescent
MH  - Alanine Transaminase/metabolism
MH  - Antibodies, Monoclonal, Humanized/*therapeutic use
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Juvenile/*drug therapy/physiopathology
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Drug Therapy, Combination
MH  - Female
MH  - Glucocorticoids/therapeutic use
MH  - Humans
MH  - Leflunomide/therapeutic use
MH  - Male
MH  - Medication Adherence
MH  - Methotrexate/therapeutic use
MH  - Neutropenia/chemically induced
MH  - Prednisolone/therapeutic use
MH  - Treatment Failure
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor Inhibitors/therapeutic use
OTO - NOTNLM
OT  - JADAS
OT  - adverse event
OT  - biological therapy
OT  - inactive disease
OT  - juvenile idiopathic arthritis
OT  - tocilizumab
EDAT- 2019/07/31 06:00
MHDA- 2020/08/22 06:00
CRDT- 2019/07/31 06:00
PHST- 2019/02/27 00:00 [received]
PHST- 2019/05/08 00:00 [revised]
PHST- 2019/07/31 06:00 [pubmed]
PHST- 2020/08/22 06:00 [medline]
PHST- 2019/07/31 06:00 [entrez]
AID - 5540361 [pii]
AID - 10.1093/rheumatology/kez291 [doi]
PST - ppublish
SO  - Rheumatology (Oxford). 2020 Apr 1;59(4):732-741. doi: 
      10.1093/rheumatology/kez291.