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Abstract Number: 1426

Higher Levels of Interleukin-6 As Well As Soluble Interleukin-6 Receptor Leads to Worse Clinical and Radiographic Prognosis in Rheumatoid Arthritis Patients Treated with Tocilizumab

Naoshi Nishina, Yuko Kaneko, Keiko Yoshimoto and Tsutomu Takeuchi, Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: interleukins (IL), rheumatoid arthritis (RA) and tocilizumab

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Session Information

Date: Monday, November 6, 2017

Session Title: Rheumatoid Arthritis – Small Molecules, Biologics and Gene Therapy Poster II: Prognostic Factors, Imaging and Miscellaneous Reports

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: We have already reported that baseline levels of soluble interluekin-6 receptor (sIL-6R), target of tocilizumab, predicted response to tocilizumab treatment in rheumatoid arthritis (RA) patients. However, there is a report that interleukin (IL)-6 is also one of predictors. The aim of this study is to investigate the association of baseline levels of both IL-6 and sIL-6R with clinical and radiographic response to tocilizumab in patients with RA.

Methods: Consecutive RA patients at our institution who received tocilizumab as the first biologic agent from April 2010 to April 2013 were included. Serum levels of sIL-6R and IL-6 were measured by electrochemiluminescence assay at week 0, 4, 24, and 52. According to baseline levels of sIL-6R and IL-6, patients were divided into 3 groups using K-means clustering. Clinical response and radiographic progression were compared among the 3 groups. Differences among 3 groups were analyzed by analysis of variance (ANOVA)

Results: Fifty six patients were enrolled. Distribution of sIL-6R and IL-6 at week 0 is shown in Figure 1 and the clusters were named as Group 1, 2 and 3. Mean levels of sIL-6R and IL-6 of Group 1 (n=29) were 46.2 ng/mL and 3.9 pg/mL; Group 2 (n=7), 65.4 ng/mL and 32.8 pg/mL; and Group 3 (n=20), 100.4 ng/ml and 5.6 pg/mL, respectively. Baseline characteristics were comparable among the groups except for RA activity. Mean disease activity score (DAS28-ESR) was higher in Group 2 compared to Group 1 and 3 (4.9 vs 6.2 vs 5.0 for Group 1, 2, and 3, respectively; p=0.02 by ANOVA). Time course of mean DAS28-ESR is shown in Figure 2. Although significant difference was observed only at week 24, mean DAS28-ESR of Group 2 tended to be higher than those of Group 1 and Group 3 (p=0.21, 0.02, and 0.08, respectively at week 4, 24, and 52). Mean yearly progression of van der Heijde modified total Sharp score was worse in Group 2 but without statistical significance (0.2 vs 2.1 vs 0.2, for Group 1, 2, and 3, respectively; p=0.07) as shown in Figure 3.

Conclusion: Despite lower levels of sIL-6R, patients with very high levels of IL-6 showed worse clinical and radiographic response to tocilizumab in RA. IL-6 as well as sIL-6R could be strong indicators for the effectiveness of tocilizumab.


Disclosure: N. Nishina, Eisai Co., Ltd., 5,Chugai Pharmaceutical Co., Ltd., 5,Mitsubishi Tanabe Pharma Corporation, 5; Y. Kaneko, AbbVie, Eisai, Daiichi Sankyo, Sanofi, 2,Bristol-Myeres Squibb, Eli Lily, Janssen, 5,AbbVie, Eisai, Astellas, Chugai Pharmaceutical, UCB, Pfizer, Bristol-Myeres Squibb, Janssen, Tanabe-Mitsubishi, Ayumi Pharmaceutical, and Takeda Pharmaceutical, Taisho-Ttoyama, 8; K. Yoshimoto, None; T. Takeuchi, Astellas Pharma Inc, Bristol–Myers K.K., Chugai Pharmaceutical Co, Ltd., Daiichi Sankyo Co., Ltd., Takeda Pharmaceutical Co., Ltd., Teijin Pharma Ltd., AbbVie GK, Asahikasei Pharma Corp., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc.,and Taisho Toyama P, 2,Astra Zeneca K.K., Eli Lilly Japan K.K., Novartis Pharma K.K., Mitsubishi Tanabe Pharma Co., Abbivie GK, Nipponkayaku Co.Ltd, Janssen Pharmaceutical K.K., Astellas Pharma Inc,. Taiho Pharmaceutical Co., Ltd.,, 5,AbbVie GK., Bristol–Myers K.K., Chugai Pharmaceutical Co,. Ltd., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., and Astellas Pharma Inc, and Diaichi Sankyo Co.,Ltd., 8.

To cite this abstract in AMA style:

Nishina N, Kaneko Y, Yoshimoto K, Takeuchi T. Higher Levels of Interleukin-6 As Well As Soluble Interleukin-6 Receptor Leads to Worse Clinical and Radiographic Prognosis in Rheumatoid Arthritis Patients Treated with Tocilizumab [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/higher-levels-of-interleukin-6-as-well-as-soluble-interleukin-6-receptor-leads-to-worse-clinical-and-radiographic-prognosis-in-rheumatoid-arthritis-patients-treated-with-tocilizumab/. Accessed February 3, 2023.
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