Obesity, comorbidities do not compromise tocilizumab effectiveness
medwireNews: Real-world study results suggest that tocilizumab has consistent effectiveness in patients with rheumatoid arthritis (RA) regardless of obesity or the presence of comorbidities.
In their analysis of patients from the Corrona RA registry who initiated tocilizumab between 2010 and 2017, the researchers found that the 356 individuals categorized as obese (BMI ≥ 30 kg/m2) experienced similar improvements in CDAI score from baseline to the 6- and 12-month follow-up visits as the 449 nonobese people, with average reductions of 7.38 versus 7.77 and 8.09 versus 8.24 points, respectively.
Similarly, average decreases from baseline in CDAI score were comparable among the 195 patients with high comorbidity burden and the 575 with low comorbidity burden at both 6 months (7.72 vs 7.57 points) and 12 months (7.82 vs 8.42 points). Comorbidity was defined according to the modified Charlson Comorbidity Index, with scores of 2 points or above indicating high burden.
These results indicate that tocilizumab “is used frequently in real world practice in patients with RA with comorbid conditions or obesity and [is] effective regardless of comorbidity burden or obesity,” write Dimitrios Pappas (New York Presbyterian Hospital, USA) and team in The Journal of Rheumatology.
Noting that the “vast majority” (93.8%) of patients used the intravenous form of tocilizumab, with dosing based on bodyweight and clinical response, they suggest that “the dose flexibility of [tocilizumab] may have improved disease control in patients who would have been nonresponders if treated with a biologic not adjusted for body weight.”
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