A comparison of clinical evaluation methods (DAS28-ESR, CDAI, SDAI and Boolean’s remission standard) of disease activity in patients with rheumatoid arthritis treated with tocilizumab

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  • 関節リウマチの各臨床的評価法（DAS28-ESR，CDAI，SDAI， Boolean基準）を用いたトシリズマブの有効性の検討

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    The definition of a new clinical remission was announced by ACR/EULAR in January, 2011. We evaluated the effectiveness on patients with rheumatoid arthritis (RA) of tocilizumab (TCZ) using various clinical composite measures (DAS 28-ESR, CDAI, SDAI, Boolean remission standard). Thirty-three RA patients treated with TCZ were investigated. Average age was 57.1 years old and the mean disease duration 13.4 years. The number of patients who had a past history of biologics was 25 (76％). DAS 28-ESR (DAS) was 5.0±1.2 at the initial administration of TCZ, 2.4±1.3 at 12 weeks and 2.2±1.3 at 24 week after administrations. SDAI was 5.0±1.2 before TCZ, 2.4±1.3 at 12-week, 2.2±1.3 at 24-week, and CDAI were 23.5±10.0, 10.1±7.9, and 8.2±7.0 respectively. All improved significantly at 12-week and 24-week.<br>     Remission rates were 73.3％ in DAS, 20.0％ in CDAI,23.3％ in SDAI, and 23.3％ in Boolean at 24-week. Remission rate of DAS was almost the same as number of the remission and low disease activity cases of CDAI and SDAI. The remission rates of CDAI, SDAI and Boolean were about 1/3of that of DAS. Although there was no significant difference in the remission rate of CDAI, SDAI, and Boolean, the remission rate of CDAI which does not include CRP or ESR, tended to be the lowest. The effectiveness of TCZ in this report showed the result equivalent to or better than most other reports which used DAS28-ESR. TCZ is a useful medicament like other biological preparations bring about remission through treat-to-target.

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