AB0358 Efficacy and Safety of Intravenous and Subcutaneous Tocilizumab in A Cohort of Patients Affected by Rheumatoid Arthritis in Real-Life

BackgroundTocilizumab (TCZ) is a humanized monoclonal anti-interleukin-6 receptor antibody, used for the treatment of moderate to severe rheumatoid arthritis (RA). Although TCZ has been proved to be highly effective and safe in RA patients in large clinical trials, few data are available from real-life practice [1].ObjectivesTo evaluate efficacy, safety and retention rate of intravenous (IV) and subcutaneous (SC) TCZ in a real-world setting.MethodsWe evaluated patients affected by moderate-to-severe RA and treated with TCZ from April 2010 to December 2015. Data of patients treated with IV-TCZ until December 2014 were collected retrospectively, while patients treated with either IV or SC-TCZ from January 2015 were included in a prospective cohort and assessed for disease activity, quality of life, treatment discontinuation and/or onset of adverse events (AEs). DAS28-CRP, CDAI and SDAI were used for activity assessment. Treatment retention rate was estimated by Kaplan-Meier method.ResultsWe evaluated 87 patients, 53 treated with IV-TCZ (8 mg/kg every 4 w), 12 with SC-TCZ (162 mg every week) and 22 patients who switched from IV to SC during follow-up (71 females, median age 61 y, median duration of disease 10 y, median follow-up 16 months). Sixty-six patients (76%) were treated in monotherapy and 21 (24%) in combination with methotrexate; 16 (18%) patients were naïve for previous biologic drugs.At baseline, disease activity was severe in 36% of patients, moderate in 59% and mild or inactive in 5%; at month 6, 49% of patients achieved a clinical remission. The mean overall DAS28 was 4.72 at baseline and 2.61 at 6 months (p