Evaluation Of Efficacy And Safety Of Tocilizumab For Rheumatoid Arthritis

Objective:By analyzing the clinical data of tocilizumab in the treatment of active rheumatoid arthritis,evaluate its efficacy and safety,to provide a reference for clinical medication.Methods:A total of 24 RA patients including 23 females and 1 male were selected from the Department of Rheumatology in our hospital from July 29,2019 to October 12,2019.The enrolled patients have been treated with one or more disease modifying anti-rheumatic drugs(including methotrexate)for more than 12 weeks,and the condition is still in a moderately highly active state(DAS28>3.2).Since the beginning of clinical observation,24 patients have been given tocilizumab 8 mg/kg intravenously(once every 4 weeks),while continuing to take oral MTX 10 mg(once a week),and collect clinical data of patients before each medication lasting total 24 weeks.Record the following indicators before each medication:number of tender joints of 28 the counted,number of swollen joints of 28 the counted,erythrocyte sedimentation rate,C-reactive protein,patient global assessment VAS score,physician global assessment,Health Assessment Questionnaire(HAQ),visual analog pain scale,and erythrocyte sedimentation rate or C-reactive protein(CRP).Then calculate the patient's DAS28 score,and record the proportion of enrolled patients with DAS28<3.2 and DAS28<2.6.Meanwhile,calculate the proportion of patients who achieved ACR20,ACR50,and ACR70 remission.Record the adverse events of patients during medication.The data at 0 week was used as the baseline data,and the post-medication data and the improvement of DAS28 and the proportion of ACR at various levels were compared with the baseline value or the previous visit data to evaluate the efficacy and safety of tocilizumab.Results:1.The number of swollen and tender joints of 28 the counted,ESR and CRP were all rapidly improved in week 8(P<0.001),and state of illness can be maintained at a low level by continuous medication.Activity of rheumatoid arthritis scored by DAS28:Active rheumatoid arthritis responds well to tocilizumab(ADAS28>1.2),The proportion of patients who reach low disease activity during treatment continues to rise(P<0.001),66.7%of patients were in low disease activity after 24 weeks,the proportions of ACR20,ACR50 and ACR70 were 95.8%,66.7%and 29.2%respectively after 24 weeks.The above data shows that tocilizumab has a rapid and effective effect on the treatment of moderately and severely active rheumatoid arthritis.2.All adverse reactions that occurred through this experiment are as follows:one case of abnormal liver function(42%),return to normal after 7 days;One case of upper respiratory tract infection(4.2%),got better after symptomatic treatment;Two cases of transient leukopenia(8.3%),both return to normal after 7 days.None of the above patients stopped medication or adjusted dosage.No serious adverse reactions were recorded in 24 weeks.Conclusions:Tocilizumab got significant efficiency in the treatment of active rheumatoid arthritis.It can significantly relieve patients' clinical symptoms,quickly reduce inflammation indicators,and achieve low disease activity without serious adverse reactions.