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An Observational Study of Tocilizumab (Actemra) in Participants With Moderate to Severe Rheumatoid Arthritis

Completed
Conditions
Rheumatoid Arthritis
Interventions
Biological: Tocilizumab
Registration Number
NCT01741688
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This observational study evaluates the use and efficacy of intravenous (IV) tocilizumab in routine clinical practice in participants with moderate to severe rheumatoid arthritis. Eligible participants initiated on tocilizumab treatment in accordance with the local label were followed for 6 months.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
16
Inclusion Criteria
  • Adults, >/= 18 years of age
  • Moderate to severe rheumatoid arthritis according to the revised (1987) American College of Rheumatology (ACR) criteria
  • Participants in whom the treating physician has made the decision to commence tocilizumab treatment (in accordance with the local label); this can include participants who have received tocilizumab treatment within 8 weeks prior to the enrollment visit
Exclusion Criteria
  • Participants who have received tocilizumab more than 8 weeks prior to the enrollment visit
  • Participants who have received treatment with any investigational agent within 4 weeks (or 5 half-lives of the investigational agent, whichever is longer) before starting treatment with tocilizumab
  • History of autoimmune disease or any joint inflammatory disease other than rheumatoid arthritis

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
TocilizumabTocilizumabParticipants with moderate to severe rheumatoid arthritis (RA), according to the American College of Rheumatology (ACR) criteria and the Disease Activity Score Based on 28 Joints (DAS28), in whom the attending physician has decided to start treatment with tocilizumab (according to the local label).
Primary Outcome Measures
NameTimeMethod
Number of Participants on Tocilizumab at 6 Months After Treatment InitiationAt 6 months
Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Systemic Manifestations of Rheumatoid ArthritisAt baseline

Systemic manifestation measured by C-reactive protein levels \> 3

Percentage of Participants Starting Tocilizumab After Prior and Baseline Disease-Modifying Anti-rheumatic Drugs (DMARDs) ExposureAt baseline

DMARDs exposure was evaluated for all participants. "Prior DMARDs treatment" includes participants, who were treated with DMARDs 6 months before being included in the study. "DMARDs treatment at baseline" includes participants, who were receiving DMARDs when they were included in the study and continued with this concomitant medication to tocilizumab.

Number of Participants Starting Tocilizumab After Failing Other Biologic AgentsAt baseline

Other biologic agents include anti-Tumor Necrosis Factor (TNF) antibody.

Median Dose at 6 MonthsAt 6 months
Number of Participants With Dose Modifications at 6 MonthsAt 6 months
Median Duration of TreatmentApproximately 16 months
Percentage of Participants Discontinued From Tocilizumab for SafetyApproximately 16 months

Safety variable measuring number of patients that discontinued tocilizumab due to adverse reactions to tocilizumab.

Percentage of Participants Discontinued From Tocilizumab for Lack of EfficacyApproximately 16 months

Efficacy variable that measures the rate of participants discontinued from tocilizumab due to lack of efficacy according to criteria of treating physician.

Number of Participants Discontinued From Tocilizumab for Other ReasonsApproximately 16 months

This variable measures the number of events not related to safety or efficacy leading to discontinuation of tocilizumab treatment.

Time to Restoration of Initial Dosing RegimenApproximately 16 months
Non-adherence Rate of Physician to the Recommended Dosing RegimenApproximately 16 months
Percentage of Participants on Tocilizumab Monotherapy at Study EntryAt baseline
Total Tender Joint Count (TJC)At Visit 1 (Baseline), Observation 1: up to 4 weeks, Observation 2: up to 8 weeks; Observation 3: up to 12 weeks; Observation 4: up to 16 weeks and Observation 5: up to 20 weeks
Total Swollen Joint Count (SJC)At Visit 1 (Baseline), Observation 1: up to 4 weeks, Observation 2: up to 8 weeks; Observation 3: up to 12 weeks; Observation 4: up to 16 weeks and Observation 5: up to 20 weeks
Disease Activity Score Based on 28 Joints (DAS28)At Visit 1 (Baseline), Observation 1: up to 4 weeks, Observation 2: up to 8 weeks; Observation 3: up to 12 weeks; Observation 4: up to 16 weeks and Observation 5: up to 20 weeks

The DAS28 is a measure of disease activity in rheumatoid arthritis (RA) and the number 28 refers to the 28 joints that are examined in this assessment. To calculate the DAS28 the following assessments are done: 1) count the number of swollen joints (out of the 28 \[sw28\]), 2) count the number of tender joints (out of the 28 \[t28\]), 3) measure Erythrocyte Sedimentation Rate (ESR), and 4) ask the participant to make a 'global assessment of health' (GH) indicated by marking a 10 cm line between very good and very bad.

The Score is developed under the follow formula:

DAS28(4) = 0.56\*sqrt(t28) + 0.28\*sqrt(sw28) + 0.70\*Ln(ESR) + 0.014\*GH Where, t=tender joints; sw=swollen joints; ESR= Erythrocyte Sedimentation Rate; GH=Global assessment of health score.

This score may range from 0 to 9.3, where a DAS28 of greater than 5.1 implies active disease, less than 3.2 low disease activity, and less than 2.6 remission.

Trial Locations

Locations (4)

Clinica San Borja; Servicio De Reumatologia

🇵🇪

Lima, Peru

Clinica El Golf

🇵🇪

San Isidro, Peru

ABK Reuma SRL- Medicentro BioCiencias

🇵🇪

Lima, Peru

Hospital de la Mujer

🇵🇪

Lima, Peru

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