Background/Purpose: In the last few year the introduction of biological agents has radically changed  the clinical outcome of patients with Rheumatoid Arthritis (RA). However, no single drug is able to control all patients with RA and it is known that each drug may be poorly effective in a sizable proportion of the treated patients. For these reasons the early identification of clinical responder patients may represent a crucial advantage for either clinical and socioeconomic reasons. Recently, mathematic algorithms, based on classical clinical parameters, have been proposed  to predict the clinical response to anti TNF and DMARDs. In the present study we have applied the mathematic algorithm  proposed to predict early response to anti TNF on our cohort of RA patients treated with tocilizumab (TCZ)

Methods: We collected the data of 61 RA patients (male: female= 52:9; mean age ± SD 50.0 ± 16.0; DAS28 at the onset:5.2±0.7; DAS28 at 1year: 1.5±0.35) followed in our unit and treated with TCZ  from Jan 2010 to Jan 2013, with a follow up of at least 12 months. The mathematic algorithm was based on the following parameters: Tender Joint, Swollen Joint, Illness activity VAS by Physician and patient, Pain VAS, ESR and CRP. It was applied to calculate the putative responders at one month of treatment and this value was compared with the DAS 28 at one month and at one year of therapy. The patients were classified as good responders if they had a delta DAS28> 1.2

Results: The mathematical model allows to predict 90% of the final responders for all treated patients, with the occurrence of 3 false negative patients. Moreover, after 1 month of therapy a delta DAS 28>1.2 was recorded in 30% of patients, while at one it was found in 88% of cases

Conclusion: these data suggest that the mathematical algorithm proposed to predict the clinical response to anti TNF, may be apply in the routine clinical practice also to RA patients treated with TCZ. Although we need further results from ongoing prospective clinical studies, it is desirable that this simple mathematical model will use to predict at one month the response in almost RA patients

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-useful-mathematical-model-able-to-predict-the-early-response-to-tocilizumab-in-rheumatoid-arthritis/