Retreatment efficacy and safety of tocilizumab in patients with rheumatoid arthritis in recurrence (RESTORE) study

ObjectivesTo evaluate the safety and efficacy of retreatment with tocilizumab (TCZ) in patients who had participated in the DREAM study (Drug free remission/low disease activity after cessation of tocilizumab [Actemar] monotherapy study) and had experienced loss of efficacy.MethodsPatients were retreated with TCZ or other disease modifying antirheumatic drugs (DMARDs). Disease activity was measured using the 28-joint disease activity score (DAS28) for 12 weeks.ResultsA total of 164 eligible patients, including 161 who experienced loss of efficacy within 52 weeks of the DREAM study, resumed treatment: 157 with TCZ and 7 with DMARDs and/or infliximab. Of TCZ-treated patients, 88.5 % (139 patients) achieved DAS28 <2.6 within 12 weeks, whereas among patients treated with DMARDs and/or infliximab only 14.3 % (1 patient) achieved DAS28 <2.6. Adverse events were observed in 70 TCZ-treated patients (44.0 %), but no serious infusion reactions were observed.ConclusionsRetreatment with TCZ was well-tolerated and effective in patients who had responded to the preceding TCZ monotherapy but had experienced loss of efficacy after cessation of TCZ.

[1]  Y. Saeki,et al.  Drug free REmission/low disease activity after cessation of tocilizumab (Actemra) Monotherapy (DREAM) study , 2013, Modern rheumatology.

[2]  Ricardo Blanco,et al.  Tocilizumab inhibits structural joint damage in rheumatoid arthritis patients with inadequate responses to methotrexate: results from the double-blind treatment phase of a randomized placebo-controlled trial of tocilizumab safety and prevention of structural joint damage at one year. , 2011, Arthritis and rheumatism.

[3]  A. Sagawa The efficacy and safety of reinstitution of tocilizumab in patients with relapsed active rheumatoid arthritis after long-term withdrawal of tocilizumab , 2011, Modern rheumatology.

[4]  David T Felson,et al.  UvA-DARE (Digital Academic Repository) American College of Rheumatology/European League against Rheumatism provisional definition of remission in rheumatoid arthritis for clinical trials , 2011 .

[5]  John Wong,et al.  EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs , 2010, Annals of the rheumatic diseases.

[6]  T. Mimori,et al.  Extended Report , 2022 .

[7]  M. Genovese,et al.  Comparison of tocilizumab monotherapy versus methotrexate monotherapy in patients with moderate to severe rheumatoid arthritis: the AMBITION study , 2009, Annals of the rheumatic diseases.

[8]  P. Robbins,et al.  Tolerogenic dendritic cells for autoimmune disease and transplantation , 2008, Annals of the rheumatic diseases.

[9]  Kazuhiko Yamamoto,et al.  Study of active controlled tocilizumab monotherapy for rheumatoid arthritis patients with an inadequate response to methotrexate (SATORI): significant reduction in disease activity and serum vascular endothelial growth factor by IL-6 receptor inhibition therapy , 2008, Modern rheumatology.

[10]  M. Genovese,et al.  Interleukin-6 receptor inhibition with tocilizumab reduces disease activity in rheumatoid arthritis with inadequate response to disease-modifying antirheumatic drugs: the tocilizumab in combination with traditional disease-modifying antirheumatic drug therapy study. , 2008, Arthritis and rheumatism.

[11]  J. Kremer,et al.  IL-6 receptor inhibition with tocilizumab improves treatment outcomes in patients with rheumatoid arthritis refractory to anti-tumour necrosis factor biologicals: results from a 24-week multicentre randomised placebo-controlled trial , 2008, Annals of the rheumatic diseases.

[12]  J. Smolen,et al.  Effect of interleukin-6 receptor inhibition with tocilizumab in patients with rheumatoid arthritis (OPTION study): a double-blind, placebo-controlled, randomised trial , 2008, The Lancet.

[13]  H. Yamanaka,et al.  Postmarketing surveillance of the safety profile of infliximab in 5000 Japanese patients with rheumatoid arthritis , 2007, Annals of the rheumatic diseases.

[14]  D. M. van der Heijde,et al.  Study of active controlled monotherapy used for rheumatoid arthritis, an IL-6 inhibitor (SAMURAI): evidence of clinical and radiographic benefit from an x ray reader-blinded randomised controlled trial of tocilizumab , 2007, Annals of the rheumatic diseases.

[15]  P. Emery,et al.  Double-blind randomized controlled clinical trial of the interleukin-6 receptor antagonist, tocilizumab, in European patients with rheumatoid arthritis who had an incomplete response to methotrexate. , 2006, Arthritis and rheumatism.

[16]  P. V. van Riel,et al.  Remission in rheumatoid arthritis: agreement of the disease activity score (DAS28) with the ARA preliminary remission criteria. , 2004, Rheumatology.

[17]  N. Miyasaka,et al.  Treatment of rheumatoid arthritis with humanized anti-interleukin-6 receptor antibody: a multicenter, double-blind, placebo-controlled trial. , 2004, Arthritis and rheumatism.

[18]  T. Kishimoto,et al.  Toxicity, pharmacokinetics, and dose-finding study of repetitive treatment with the humanized anti-interleukin 6 receptor antibody MRA in rheumatoid arthritis. Phase I/II clinical study. , 2003, The Journal of rheumatology.

[19]  R. Price,et al.  Therapeutic benefit of blocking interleukin-6 activity with an anti-interleukin-6 receptor monoclonal antibody in rheumatoid arthritis: a randomized, double-blind, placebo-controlled, dose-escalation trial. , 2002, Arthritis and rheumatism.

[20]  M. Malaise,et al.  Matrix metalloproteinase-3 serum levels are correlated with disease activity and predict clinical response in rheumatoid arthritis. , 2000, The Journal of rheumatology.

[21]  S SmolenJosef,et al.  EULAR (欧州リウマチ学会) 合成および疾患修飾性抗リウマチ生物学的製剤による関節リウマチ管理に関する推奨ガイドライン | 文献情報 | J-GLOBAL 科学技術総合リンクセンター , 2010 .