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Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation: A post hoc analysis of the SURPRISE study

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Title: Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation: A post hoc analysis of the SURPRISE study
Authors: Kato, Masaru Browse this author →KAKEN DB
Kaneko, Yuko Browse this author →KAKEN DB
Tanaka, Yoshiya Browse this author →KAKEN DB
Inoo, Masayuki Browse this author
Kobayashi-Haraoka, Hitomi Browse this author
Amano, Koichi Browse this author →KAKEN DB
Miyata, Masayuki Browse this author
Murakawa, Yohko Browse this author
Yasuoka, Hidekata Browse this author
Hirata, Shintaro Browse this author →KAKEN DB
Nagasawa, Hayato Browse this author →KAKEN DB
Tanaka, Eiichi Browse this author
Miyasaka, Nobuyuki Browse this author →KAKEN DB
Yamanaka, Hisashi Browse this author →KAKEN DB
Yamamoto, Kazuhiko Browse this author →KAKEN DB
Yokota, Isao Browse this author →KAKEN DB
Atsumi, Tatsuya Browse this author →KAKEN DB
Takeuchi, Tsutomu Browse this author →KAKEN DB
Keywords: Monotherapy
serum amyloid A
Issue Date: 7-Jun-2019
Publisher: Taylor & Francis
Journal Title: Modern rheumatology
Volume: 30
Issue: 3
Start Page: 442
End Page: 449
Publisher DOI: 10.1080/14397595.2019.1621026
PMID: 31106666
Abstract: Objectives: 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.
Rights: This is an Accepted Manuscript of an article published by Taylor & Francis in Modern rheumatology on 07 Jun 2019, available online:
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 加藤 将

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