2024-03-29T14:42:07Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/811142022-11-17T02:08:08Zhdl_2115_20043hdl_2115_137Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation: A post hoc analysis of the SURPRISE study1000010755896Kato, Masaru1000060317112Kaneko, Yuko1000030248562Tanaka, YoshiyaInoo, MasayukiKobayashi-Haraoka, Hitomi1000000175928Amano, KoichiMiyata, MasayukiMurakawa, YohkoYasuoka, Hidekata1000090525461Hirata, Shintaro1000020306343Nagasawa, HayatoTanaka, Eiichi1000030157622Miyasaka, Nobuyuki1000010166754Yamanaka, Hisashi1000080191394Yamamoto, Kazuhiko1000020761414Yokota, Isao1000020301905Atsumi, Tatsuya1000050179610Takeuchi, Tsutomuopen accessThis is an Accepted Manuscript of an article published by Taylor & Francis in Modern rheumatology on 07 Jun 2019, available online:http://www.tandfonline.com/10.1080/14397595.2019.1621026.Monotherapypredictionremissionserum amyloid Atocilizumab490Objectives: To identify predictive factors for remission by tocilizumab monotherapy in rheumatoid arthritis (RA) patients. Methods: This is a post hoc analysis of the SURPRISE study, a 2-year randomized, controlled study comparing the efficacy of tocilizumab with (ADD-ON) and without methotrexate (SWITCH). The primary endpoint was DAS28-ESR remission (<2.6) at week 24. The change in modified total Sharp score from baseline to week 52 (Delta mTSS/year) was also assessed as an endpoint. The effect of clinical parameters at baseline on remission was estimated by logistic regression analysis. Results: In SWITCH (n = 96), CRP, SAA, RF, and DAS28 at baseline showed predictive value for DAS28 remission in unadjusted analysis. Adjusted analysis confirmed SAA and DAS28 as predictive factors, with SAA having the highest value (ROC-AUC = 0.731). Furthermore, structural remission (Delta mTSS/year <= 0.5) rate was significantly higher in patients with SAA of < 50.0 mu g/mL than other patients. In contrast, in ADD-ON (n = 98), only DAS28 showed predictive value for DAS28 remission. In patients with SAA < 50.0 mu g/mL, both DAS28 remission and structural remission rate were comparable between SWITCH and ADD-ON. Conclusion: RA patients with low SAA levels at baseline may benefit similarly from tocilizumab with and without methotrexate.Taylor & Francis2019-06-07engjournal articleAMhttp://hdl.handle.net/2115/81114https://doi.org/10.1080/14397595.2019.1621026311066661439-7595Modern rheumatology303442449https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/81114/1/Mod%20Rheumatol%202019%20Jun.pdfapplication/pdf1.52 MB2019-06-07https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/81114/2/Table%20S1.docxapplication/vnd.openxmlformats-officedocument.wordprocessingml.document18.81 KB2019-06-07https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/81114/3/Table%20S2.docxapplication/vnd.openxmlformats-officedocument.wordprocessingml.document19.24 KB2019-06-07https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/81114/4/Table%20S3.docxapplication/vnd.openxmlformats-officedocument.wordprocessingml.document19.08 KB2019-06-07