SAT0125 Tocilizumab Achieves Rapid Reduction of Disease Activity and Has Beneficial Effects on Bone Mineral Density in Patients with Rheumatoid Arthritis – Results of A Prospective 5- Year Study

BackgroundTocilizumab (TCZ) leads to a rapid improvement of the clinical course in patients with highly active rheumatoid arthritis (RA). However, a residual rheumatic activity can still be detected.1 RA is a known risk factor for osteoporosis related bone fractures.2 It is well established that TCZ has beneficial effects on bone remodeling.3ObjectivesThe aim of this analysis was to investigate the effects of TCZ on bone mineral density in a real world patient population.Methods50 rheumatoid factor positive patients with RA (17 male, age 20–72 years) who received TCZ as monotherapy since 2008 were prospectively investigated. At baseline and the following 4–6 clinical visits, DAS28 was determined and ultrasound performed. At baseline and every 6 months thereafter, biochemical parameters for bone metabolism and protein diagnostics were recorded. Once a year, the subjects underwent MRI, CT and DXA scan.ResultsIn all 50 patients the DAS28 normalized at the latest by the 3rd infusion cycle of TCZ. The initial RAMRIS score of >5 was reduced to 2.7. 2 patients presented with pustular dermatosis in the palms. No allergic reactions were observed.ConclusionsTreatment with TCZ leads to a rapid decline of inflammatory activity of the affected joints in patients with RA and minimizes cartilage destruction. TCZ showed a positive effect on bone remodeling and therefore BMD. Thus, the risk for the development of osteoporosis and its related fractures can be minimized by TCZ treatment. Furthermore, TCZ has a positiv