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Please use this identifier to cite or link to this item: http://ir.fmu.ac.jp/dspace/handle/123456789/1954

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Title: Feasibility of methotrexate discontinuation following tocilizumab and methotrexate combination therapy in patients with long-standing and advanced rheumatoid arthritis: a 3-year observational cohort study
Authors: Miyata, Masayuki
Hirabayashi, Yasuhiko
Munakata, Yasuhiko
Urata, Yukitomo
Saito, Koichi
Okuno, Hiroshi
Yoshida, Masaaki
Kodera, Takao
Watanabe, Ryu
Miyamoto, Seiya
Ishii, Tomonori
Nakazawa, Shigeshi
Takemori, Hiromitsu
Ando, Takanobu
Kanno, Takashi
Komagamine, Masataka
Kato, Ichiro
Takahashi, Yuichi
Komatsuda, Atsushi
Endo, Kojiro
Murai, Chihiro
Takakubo, Yuya
Miura, Takao
Sato, Yukio
Ichikawa, Kazunobu
Konta, Tsuneo
Chiba, Noriyuki
Muryoi, Tai
Kobayashi, Hiroko
Fujii, Hiroshi
Sekiguchi, Yukio
Hatakeyama, Akira
Ogura, Ken
Sakuraba, Hirotake
Asano, Tomoyuki
Kanazawa, Hiroshi
Suzuki, Eiji
Takasaki, Satoshi
Asakura, Kenichi
Suzuki, Yoko
Takagi, Michiaki
Nakayama, Takahiro
Watanabe, Hiroshi
Miura, Keiki
Mori, Yu
Affiliation: リウマチ膠原病内科学講座
Source title: Fukushima Journal of Medical Science
Volume: 69
Issue: 1
Start page: 11
End page: 20
Issue Date: 2023
Abstract: Objectives: Methotrexate (MTX) is associated with extensive side effects, including myelosuppression, interstitial pneumonia, and infection. It is, therefore, critical to establish whether its administration is required after achieving remission with tocilizumab (TCZ) and MTX combination therapy in patients with rheumatoid arthritis (RA). Therefore, the aim of this multicenter, observational, cohort study was to evaluate the feasibility of MTX discontinuation for the safety of these patients. Methods: Patients with RA were administered TCZ, with or without MTX, for 3 years; those who received TCZ+MTX combination therapy were selected. After remission was achieved, MTX was discontinued without flare development in one group (discontinued [DISC] group, n = 33) and continued without flare development in another group (maintain [MAIN] group, n = 37). The clinical efficacy of TCZ+MTX therapy, patient background characteristics, and adverse events were compared between groups. Results: The disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) at 3, 6, and 9 months was significantly lower in the DISC group (P < .05, P < .01, and P < .01, respectively). Further, the DAS28-ESR remission rate at 6 and 9 months and Boolean remission rate at 6 months were significantly higher in the DISC group (P < .01 for all). Disease duration was significantly longer in the DISC group (P < .05). Furthermore, the number of patients with stage 4 RA was significantly higher in the DISC group (P < .01). Conclusions: Once remission was achieved, MTX was discontinued in patients who responded favorably to TCZ+MTX therapy, despite the prolonged disease duration and stage progression.
Publisher: The Fukushima Society of Medical Science
Publisher (Alternative foam): 福島医学会
language: eng
URI: http://ir.fmu.ac.jp/dspace/handle/123456789/1954
Full text URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/1954/1/FksmJMedSci_69_p11.pdf
ISSN: 0016-2590
DOI: 10.5387/fms.2022-06
PubMed ID: 36990790
Related Page: https://doi.org/10.5387/fms.2022-06
Rights: © 2023 The Fukushima Society of Medical Science. This article is licensed under a Creative Commons [Attribution-NonCommercial-ShareAlike 4.0 International] license.
Rights: https://creativecommons.org/licenses/by-nc-sa/4.0/
Appears in Collections:Vol.69 (2023)

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