The add-on effectiveness and safety of iguratimod in patients with rheumatoid arthritis who showed an inadequate response to tocilizumab

Ebina, Kosuke; Miyama, Akira; Tsuboi, Hideki; Kaneshiro, Shoichi; Nishikawa, Masataka; Owaki, Hajime; Tsuji, Shigeyoshi; Hirao, Makoto; Etani, Yuki; Goshima, Atsushi; Hashimoto, Jun; Yoshikawa, Hideki

doi:https://doi.org/10.1080/14397595.2018.1486939

The add-on effectiveness and safety of iguratimod in patients with rheumatoid arthritis who showed an inadequate response to tocilizumab

Ebina, Kosuke; Miyama, Akira; Tsuboi, Hideki et al.

Modern Rheumatology, 2019, 29(4), 581-588

Number of Access:1,319（2025-09-03 11:38 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/93253

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Title	The add-on effectiveness and safety of iguratimod in patients with rheumatoid arthritis who showed an inadequate response to tocilizumab
Creator	NRID 1000070612076 1000070612076 researchmap permalink k-ebina k-ebina Scopus Author ID 8415453300 8415453300 ORCID 0000-0002-2426-1024 0000-0002-2426-1024 CreatorName Ebina, Kosuke
	CreatorName Miyama, Akira
	CreatorName Tsuboi, Hideki
	CreatorName Kaneshiro, Shoichi
	CreatorName Nishikawa, Masataka
	CreatorName Owaki, Hajime
	CreatorName Tsuji, Shigeyoshi
	NRID 1000010527708 1000010527708 CreatorName Hirao, Makoto
	NRID 1000060898930 1000060898930 CreatorName Etani, Yuki
	CreatorName Goshima, Atsushi
	NRID 1000040237938 1000040237938 CreatorName Hashimoto, Jun
	NRID 1000060191558 1000060191558 CreatorName Yoshikawa, Hideki
Subject	Iguratimod
	inadequate response
	rheumatoid arthritis
	tocilizumab
Description	Ebina K., Miyama A., Tsuboi H., et al. The add-on effectiveness and safety of iguratimod in patients with rheumatoid arthritis who showed an inadequate response to tocilizumab. Modern Rheumatology 29, 581 (2019); https://doi.org/10.1080/14397595.2018.1486939.
Abstract	Objectives: To evaluate the effectiveness of add-on iguratimod (IGU) in patients with rheumatoid arthritis (RA) who showed an inadequate response to tocilizumab (TCZ), especially patients who were intolerant of an effective dose of methotrexate (MTX). Methods: Thirty-one patients with RA (22 women, age 62.4 years, disease duration 13.8 years, prior TCZ duration 35.7 months, 25 intravenous [8 mg/kg/4 weeks] and 6 subcutaneous [162 mg/2 weeks] TCZ treatments, concomitant MTX 8.5 mg/week [35.5%], and prednisolone (PSL) 4.3 mg/day [25.8%]) who showed an inadequate response to TCZ (disease activity score assessing 28 joints with C-reactive protein [DAS28-CRP] 2.9, clinical disease activity index [CDAI] 15.0, 28 secondary inadequate responders) were treated with additional IGU (final dose 41.7 mg/day) and enrolled in this 24-week, multicenter, retrospective study. Results: Twenty-nine patients (93.5%) continued the treatment for 24 weeks (one dropped out for pneumonia and one for digestive symptoms). The TCZ and the concomitant dose and rate of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (MTX, salazosulfapyridine [SASP], and tacrolimus [TAC]) were not significantly changed during this period. Outcome measures improved significantly, as follows: DAS28-CRP from 2.9 to 1.7 (p <.001); CDAI from 15.0 to 6.0 (p <.001); modified Health Assessment Questionnaire (mHAQ) from 0.8 to 0.6 (p <.05); and rheumatoid factor (RF) from 382.1 to 240.3 IU/mL (p <.001). Using the EULAR criteria, 64.5% achieved a moderate response, and 51.6% achieved ACR 20 at 24 weeks. Conclusion: Adding IGU to inadequate responders to TCZ may be a promising and safe complementary treatment option.
Publisher	Taylor and Francis Ltd
Source Title	Modern Rheumatology
Volume (Issue)	29(4)
Page	581-588
Date of Issued	2019-07-04
Language	English
Handle URL	https://hdl.handle.net/11094/93253
PISSN	14397595
eISSN	14397609
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1080/14397595.2018.1486939
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Modern Rheumatology. 2019, 29(4), p. 581-588
DC.title	The add-on effectiveness and safety of iguratimod in patients with rheumatoid arthritis who showed an inadequate response to tocilizumab
DC.creator	Ebina, Kosuke
	Miyama, Akira
	Tsuboi, Hideki
	Kaneshiro, Shoichi
	Nishikawa, Masataka
	Owaki, Hajime
	Tsuji, Shigeyoshi
	Hirao, Makoto
	Etani, Yuki
	Goshima, Atsushi
	Hashimoto, Jun
	Yoshikawa, Hideki
DC.publisher	Taylor and Francis Ltd
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2019-07-04
DC.identifier	https://doi.org/10.1080/14397595.2018.1486939
DC.subject	Iguratimod
	inadequate response
	rheumatoid arthritis
	tocilizumab
DC.description	Ebina K., Miyama A., Tsuboi H., et al. The add-on effectiveness and safety of iguratimod in patients with rheumatoid arthritis who showed an inadequate response to tocilizumab. Modern Rheumatology 29, 581 (2019); https://doi.org/10.1080/14397595.2018.1486939.
DCTERMS.abstract	Objectives: To evaluate the effectiveness of add-on iguratimod (IGU) in patients with rheumatoid arthritis (RA) who showed an inadequate response to tocilizumab (TCZ), especially patients who were intolerant of an effective dose of methotrexate (MTX). Methods: Thirty-one patients with RA (22 women, age 62.4 years, disease duration 13.8 years, prior TCZ duration 35.7 months, 25 intravenous [8 mg/kg/4 weeks] and 6 subcutaneous [162 mg/2 weeks] TCZ treatments, concomitant MTX 8.5 mg/week [35.5%], and prednisolone (PSL) 4.3 mg/day [25.8%]) who showed an inadequate response to TCZ (disease activity score assessing 28 joints with C-reactive protein [DAS28-CRP] 2.9, clinical disease activity index [CDAI] 15.0, 28 secondary inadequate responders) were treated with additional IGU (final dose 41.7 mg/day) and enrolled in this 24-week, multicenter, retrospective study. Results: Twenty-nine patients (93.5%) continued the treatment for 24 weeks (one dropped out for pneumonia and one for digestive symptoms). The TCZ and the concomitant dose and rate of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (MTX, salazosulfapyridine [SASP], and tacrolimus [TAC]) were not significantly changed during this period. Outcome measures improved significantly, as follows: DAS28-CRP from 2.9 to 1.7 (p <.001); CDAI from 15.0 to 6.0 (p <.001); modified Health Assessment Questionnaire (mHAQ) from 0.8 to 0.6 (p <.05); and rheumatoid factor (RF) from 382.1 to 240.3 IU/mL (p <.001). Using the EULAR criteria, 64.5% achieved a moderate response, and 51.6% achieved ACR 20 at 24 weeks. Conclusion: Adding IGU to inadequate responders to TCZ may be a promising and safe complementary treatment option.
DC.rights	This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
DC.format	93253
citation_title	The add-on effectiveness and safety of iguratimod in patients with rheumatoid arthritis who showed an inadequate response to tocilizumab
citation_author	Ebina, Kosuke
	Miyama, Akira
	Tsuboi, Hideki
	Kaneshiro, Shoichi
	Nishikawa, Masataka
	Owaki, Hajime
	Tsuji, Shigeyoshi
	Hirao, Makoto
	Etani, Yuki
	Goshima, Atsushi
	Hashimoto, Jun
	Yoshikawa, Hideki
citation_publisher	Taylor and Francis Ltd
citation_language	English
citation_date	2019-07-04
citation_journal_title	Modern Rheumatology
citation_volume	29
citation_issue	4
citation_firstpage	581
citation_lastpage	588
citation_doi	https://doi.org/10.1080/14397595.2018.1486939
citation_public_url	https://hdl.handle.net/11094/93253

The add-on effectiveness and safety of iguratimod in patients with rheumatoid arthritis who showed an inadequate response to tocilizumab

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