ヤマナカ　ヒサシ   Yamanaka Hisashi   山中　寿    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation: A post hoc analysis of the SURPRISE study.
掲載誌名	正式名：Modern rheumatology 略　 称：Mod Rheumatol ISSNコード：14397609/14397595
掲載区分	国外
巻・号・頁	30(3),pp.442-449
著者・共著者	Kato Masaru, Kaneko Yuko, Tanaka Yoshiya, Inoo Masayuki, Kobayashi-Haraoka Hitomi, Amano Koichi, Miyata Masayuki, Murakawa Yohko, Yasuoka Hidekata, Hirata Shintaro, Nagasawa Hayato, Tanaka Eiichi, Miyasaka Nobuyuki, Yamanaka Hisashi, Yamamoto Kazuhiko, Yokota Isao, Atsumi Tatsuya, Takeuchi Tsutomu
発行年月	2020/05
概要	Objectives: To identify predictive factors for remission by tocilizumab monotherapy in rheumatoid arthritis (RA) patients.Methods: This is a post hoc analysis of the SURPRISE study, a 2-year randomized, controlled study comparing the efficacy of tocilizumab with (ADD-ON) and without methotrexate (SWITCH). The primary endpoint was DAS28-ESR remission (<2.6) at week 24. The change in modified total Sharp score from baseline to week 52 (ΔmTSS/year) was also assessed as an endpoint. The effect of clinical parameters at baseline on remission was estimated by logistic regression analysis.Results: In SWITCH (n = 96), CRP, SAA, RF, and DAS28 at baseline showed predictive value for DAS28 remission in unadjusted analysis. Adjusted analysis confirmed SAA and DAS28 as predictive factors, with SAA having the highest value (ROC-AUC = 0.731). Furthermore, structural remission (ΔmTSS/year ≤ 0.5) rate was significantly higher in patients with SAA of < 50.0 μg/mL than other patients. In contrast, in ADD-ON (n = 98), only DAS28 showed predictive value for DAS28 remission. In patients with SAA < 50.0 μg/mL, both DAS28 remission and structural remission rate were comparable between SWITCH and ADD-ON.Conclusion: RA patients with low SAA levels at baseline may benefit similarly from tocilizumab with and without methotrexate.Trial registration number: NCT01120366.
DOI	10.1080/14397595.2019.1621026
PMID	31106666