Results of tocilizumab treatment in patients with rheumatoid arthritis

Abstract

The aim of the work was to study the results of tocilizumab (TCZ) treatment in patients with high and moderate activity of rheumatoid arthritis (RA) in addition to basic therapy. The objectives of the work are to assess the degree of RA activity before and after intravenous administration of TCZ using the DAS–28 scale, as well as to compare the effectiveness of TCZ in groups of patients with initially different degrees of activity and the radiological stage of RA. Materials and methods. The study included 58 people with an established diagnosis of RA receiving basic therapy in combination with the biological drug TCZ (India) over the period from 04.2022 to 09.2022. After the consultation decision and the patient informed consent had been obtained, intravenous infusion with a solution of TCZ at the rate of 8 mg/kg was performed once a month for up to 5 courses. Evaluation of the effectiveness of therapy was carried out by analyzing the activity of the disease with the use of DAS-28 scale (including a subjective assessment of pain on a visual analog scale, the number of painful and swollen joints and laboratory indicators of ESR, CRP) before and after each subsequent administration of the drug. Results. The radiological stage of RA correlated with the disease duration (R=0.8). In patients with initial radiological changes, the activity was lower (DAS-28 according to ESR) of RA (p=0.03). High clinical efficacy and safety of TCZ therapy in patients with an initially high and moderate degree of disease activity has been established. In all patients, there was a significant decrease in RA activity according to the DAS-28 scale (according to CRP and ESR) after TCZ injections (p<0.05). Clinical and laboratory remission occurred in 12% of subjects after the second injection, in 44% of patients – after the fourth (significantly more often than after the second injection, p=0.0274), in 37.5% – after the fifth injection of TCZ.