ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2364

Baseline Procalcitonin Levels Are Predictive Marker Of Remission In Biologic naïve Patients With Rheumatoid Arthritis Treated With Tocilizumab: Result From 24 Weeks Of Follow-Up

Soichiro Tsuji1, Akiko Yura2, Michihito Katayama1, Satoru Teshigawara1, Maiko Yoshimura1, Eriko Tanaka1, Yoshinori Harada2, Yoshinori Katada2, Masato Matsushita3, Shiro Ohshima4, Jun Hashimoto1 and Yukihiko Saeki4, 1Dept of Rheumatology, Rheumatology,Osaka-Minami Medical Center, Kawachinagano City, Japan, 2Dept of Allergology, Allergology,Osaka-Minami Medical Center, Kawachinagano City, Japan, 3Rheumatology, Rheumatology,Osaka-Minami Medical Center, Kawachinagano City, Japan, 4Dept of Clinical Research, Clinical Research,Osaka-Minami Medical Center, Kawachinagano City, Japan

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Rheumatoid Arthritis Treatment - Small Molecules, Biologics and Gene Therapy III

Session Type: Abstract Submissions (ACR)

Background/Purpose: , :Procalcitonin(PCT) is a useful marker of infection. PCT-mRNA increases expression from peripheral blood mononuclear cells by stimulation of a pro inflammatory cytokine, IL-6 and TNF-α. Of the 216 Rheumatoid arthritis(RA) patients who started tocilizumab(TCZ) treatment until September 2012 at our center, about half of the patients did not attain remission after 24 weeks, and therefore, predictive marker will be useful for patient care.To purpose of this study is to investigate whether the levels of PCT, modified HAQ(mHAQ), MMP-3, RF, ESR, CRP, and ACPA at baseline(BL) of TCZ treatment can be used to predict remission at 24 weeks after the start of TCZ treatment(Week 24). 

Methods: Biologic(Bio) naïve RA patients treated with TCZ for more than 24 weeks were enrolled in this study. PCT(n=30), mHAQ(n=71), MMP-3(n=98), RF(n=89), ESR(n=94), CRP(n=101) and ACPA(n=81) were identified at BL. The patients were divided into 2 groups, based on DAS28ESR remission(DAS28ESR<2.6) at Week 24. For each variable, there was a significant difference between the remission and non-remission group; ROC analysis was performed and cut-off values(COV) were analyzed. For each of these variables, 2 groups were formed by dividing the Bio naïve RA at the COV: the under COV (U) group and over COV (O) group, and the Week 24 remission rate in each group was found

Results: The variables with significant difference between the remission and non-remission group were PCT(p=0.013), mHAQ(p<0.000), MMP-3(p=0.028), RF(p<0.000), ESR(p<0.000) and CRP(p<0.000). The COVs were 0.026ng/ml for PCT, 0.5 for mHAQ, 85mg/dl for MMP-3, 94U/ml for RF, 56mm/hr for ESR, and 1.09mg/dl for CRP. For each variable, the remission rate in the U group(PCT 91.7%, mHAQ 82.2%, MMP-3 68.8%, RF 72.3%, ESR 63.2% and CRP 65.2%) was significantly higher than in the O group. For PCT at BL, DAS28ESR was no different between the U group and O group and no correlation with DAS28ESR was observed. But the BL DAS28ESR was significantly lower in the U groups for other variables.

Conclusion: Baseline PCT level is a useful marker of predictive remission at week 24 in Bio naïve RA patients treated with TCZ. Moreover, unlike the other variables, it is not affected by the BL disease activity level.

Disclosure:

S. Tsuji,
None;

A. Yura,
None;

M. Katayama,
None;

S. Teshigawara,
None;

M. Yoshimura,
None;

E. Tanaka,
None;

Y. Harada,
None;

Y. Katada,
None;

M. Matsushita,
None;

S. Ohshima,
None;

J. Hashimoto,
None;

Y. Saeki,
None.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/baseline-procalcitonin-levels-are-predictive-marker-of-remission-in-biologic-naive-patients-with-rheumatoid-arthritis-treated-with-tocilizumab-result-from-24-weeks-of-follow-up/