TOCILIZUMAB: EFFICACY AND TOLERANCE IN RHEUMATOID ARTHRITIS IN CURRENT PRACTICE

Abstract

Introduction : L’objectif de ce travail etait d’evaluer dans la vraie vie l’efficacite et la tolerance du Tocilizumab dans le traitement de la polyarthrite rhumatoide (PR). Materiels et methodes : Etude transversale observationnelle incluant des patients atteints de PR, traites par le Tocilizumab a la dose recommandee de 8 mg/kg/4 semaines. La reponse therapeutique a ete evaluee par le score EULAR DAS 28 CRP/VS au 3eme mois et au 6eme mois du traitement. Resultats : La PR etait souvent severe (76,5%), seropositive (88,2%) et erosive (81,3%). Le tocilizumab etait prescrit en deuxieme intention apres une biotherapie anterieure chez 23 % des patientes et utilise en monotherapie dans 76,5 % des patients. Respectivement a l’inclusion, a trois mois et a six mois du traitement par le Tocilizumab, une amelioration statistiquement significative et continue des differents parametres a ete obtenue avec : l’EVA douleur (p=0,000), la CRP (mg/L) (p=0,000), la VS (mmH1) (p=0,000), le DAS 28 CRP (p=0,000) et le DAS 28 VS (p=0,000). En dehors d’une aggravation de la fonction renale chez une patiente contre-indiquant la poursuite du Tocilizumab, aucun effet secondaire grave n’a ete note. Conclusion : Notre etude confirme l'efficacite du Tocilizumab et sa bonne tolerance chez nos patients marocains atteints de PR. Mots clefs : polyarthrite rhumatoide, tocilizumab, efficacite, tolerance ABSTRACT Introduction: The aim of this study was to evaluate in “real life” the efficacy and the tolerance of Tocilizumab (TCZ) in the treatment of rhumatoide arthritis (RA). Materials and methods: A cross-sectional study including patients with RA patients treated with TCZ at the commended dose of 8 mg/kg/ 4 weeks. The therapeutic response was evaluated by the EULAR DAS 28 ‐CRP/ VS at month 3 and month 6 of treatment. Results: RA was in most cases severe (76,5 %), seropositive (88,2 %) and erosive (81,3 %). TCZ was prescribed as an alternative to a previous biotherapy in 23 % of the patients and in monotherapy in 76, 5 % of the patients. After treatment follow-up at 3 and 6 months, the different parameters observed were significantly improved including: VAS (visual analogue scale) pain (p=0,000), CRP (mg/L) p=0,000), ESR (mmH1) (p=0,000), DAS 28 CRP (p=0,000), and DAS 28 ESR (p=0,000). Apart from a worsening of renal function in a patient contraindicated continuation of tocilizumab, no serious side effects were noted. Conclusion: Our study confirmed the efficacy and tolerance of TCZ therapy in Moroccan patients suffering from RA. Key words: rheumatoid arthritis, tocilizumab, efficacy, tolerance