Comparative Study

. 2021 Jul;41(7):1233-1241.

doi: 10.1007/s00296-021-04862-y. Epub 2021 Apr 26.

Comparison of efficacy between anti-IL-6 receptor antibody and other biological disease-modifying antirheumatic drugs in the patients with rheumatoid arthritis who have knee joint involvement: the ANSWER cohort, retrospective study

Yuichi Maeda^{1

2}, Toru Hirano³, Kosuke Ebina⁴, Ryota Hara⁵, Motomu Hashimoto⁶, Wataru Yamamoto⁷, Kosaku Murakami⁸, Takuya Kotani⁹, Kenichiro Hata⁹, Yonsu Son¹⁰, Hideki Amuro¹⁰, Akira Onishi¹¹, Sadao Jinno¹¹, Masaki Katayama¹², Atsushi Kumanogoh^{3

13}

Affiliations

¹ Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan. ymaeda@imed3.med.osaka-u.ac.jp.
² Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan. ymaeda@imed3.med.osaka-u.ac.jp.
³ Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan.
⁴ Department of Musculoskeletal Regenerative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
⁵ The Center for Rheumatic Diseases, Nara Medical University, Kashihara, Japan.
⁶ Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁷ Health Information Management, Kurashiki Sweet Hospital, Kurashiki, Japan.
⁸ Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁹ Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Japan.
¹⁰ First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan.
¹¹ Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan.
¹² Department of Rheumatology, Osaka Red Cross Hospital, Osaka, Japan.
¹³ Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan.

PMID: 33903963
DOI: 10.1007/s00296-021-04862-y

Comparative Study

Comparison of efficacy between anti-IL-6 receptor antibody and other biological disease-modifying antirheumatic drugs in the patients with rheumatoid arthritis who have knee joint involvement: the ANSWER cohort, retrospective study

Yuichi Maeda et al. Rheumatol Int. 2021 Jul.

. 2021 Jul;41(7):1233-1241.

doi: 10.1007/s00296-021-04862-y. Epub 2021 Apr 26.

Authors

Affiliations

¹ Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan. ymaeda@imed3.med.osaka-u.ac.jp.
² Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan. ymaeda@imed3.med.osaka-u.ac.jp.
³ Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan.
⁴ Department of Musculoskeletal Regenerative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
⁵ The Center for Rheumatic Diseases, Nara Medical University, Kashihara, Japan.
⁶ Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁷ Health Information Management, Kurashiki Sweet Hospital, Kurashiki, Japan.
⁸ Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁹ Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Japan.
¹⁰ First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan.
¹¹ Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan.
¹² Department of Rheumatology, Osaka Red Cross Hospital, Osaka, Japan.
¹³ Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan.

PMID: 33903963
DOI: 10.1007/s00296-021-04862-y

Abstract

Objective: We aimed to investigate the efficacy of anti-IL-6 receptor antibody (aIL-6) and other biologic disease-modifying antirheumatic drugs (bDMARDs), such as TNF inhibitor and CTLA4-Ig in the treatment of rheumatoid arthritis (RA) in patients with knee joint involvement.

Methods: We retrospectively analyzed 1059 treatment courses of patients with RA who visited our hospitals and were treated with bDMARDs. We categorized them into two groups, with or without knee joint involvement. We investigated the clinical disease activity index (CDAI) at baseline and 12 weeks after the initiation of bDMARDs. We compared the improvement of the markers between aIL-6 and other bDMARDs.

Results: Treatment with aIL-6 significantly increased ΔCDAI (n = 91, 15.4 ± 1.1; mean ± SEM) in patients with knee joint involvement, compared to other bDMARDs (n = 232, 11.0 ± 0.7) at 12 weeks (P = 0.006). Following the multivariate analysis adjusted by the CDAI levels at baseline, age, gender, concomitant use of methotrexate, and the first use of bDMARDs, ΔCDAI levels were significantly higher in aIL-6, compared to other bDMARDs (P = 0.02). However, there was no significant difference in ΔCDAI improvement between aIL-6 (n = 162, 5.9 ± 0.6) and other bDMARDs (n = 573, 6.2 ± 0.4) in patients without swollen knee joints. ΔCDAI levels were equally increased in patients with shoulder and elbow joint involvement.

Conclusion: aIL-6 was more effective in the patients with RA and knee joint involvement, compared to other bDMARDs.

Keywords: Antirheumatic agents; Interleukin-6; Rheumatoid arthritis.

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Comparison of efficacy between anti-IL-6 receptor antibody and other biological disease-modifying antirheumatic drugs in the patients with rheumatoid arthritis who have knee joint involvement: the ANSWER cohort, retrospective study

Affiliations

Comparison of efficacy between anti-IL-6 receptor antibody and other biological disease-modifying antirheumatic drugs in the patients with rheumatoid arthritis who have knee joint involvement: the ANSWER cohort, retrospective study

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