University of Oulu

Grönlund, M.-M., Remes-Pakarinen, T., Kröger, L., Markula-Patjas, K., Backström, M., Putto-Laurila, A., … Vähäsalo, P. (2019). Efficacy and safety of tocilizumab in a real-life observational cohort of patients with polyarticular juvenile idiopathic arthritis. Rheumatology.

Efficacy and safety of tocilizumab in a real-life observational cohort of patients with polyarticular juvenile idiopathic arthritis

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Author: Grönlund, Minna-Maija1; Remes-Pakarinen, Terhi2; Kröger, Liisa2;
Organizations: 1Department of Pediatrics, Turku University Hospital, Turku
2Department of Pediatrics, Kuopio University Hospital, Kuopio
3Department of Paediatrics, Tampere University Hospital, Tampere
4University of Tampere, Tampere
5Department of Pediatrics, Vaasa Central Hospital, Vaasa
6Department of Children and Adolescents, Helsinki University Hospital, Helsinki
7Pediatric Research Center, University of Helsinki, Helsinki
8Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu
9Department of Children and Adolescents, Oulu University Hospital, Oulu
10PEDEGO Research Unit, University of Oulu, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link:
Language: English
Published: Oxford University Press, 2020
Publish Date: 2020-07-29


Objectives: To evaluate the patterns of usage, efficacy and safety of tocilizumab in polyarticular JIA.

Methods: An observational study of 56 consecutive polyarticular JIA patients was conducted using patient charts and electronic JIA databases. Efficacy was assessed by tocilizumab survival, rates of low disease activity (LDA) and of inactive disease by 10-joint Juvenile Arthritis Disease Activity Score (JADAS-10), and of clinically inactive disease according to Wallace’s preliminary criteria. Efficacy and rate of adverse events (AEs) were evaluated during a 24-month period after tocilizumab commencement.

Results: Tocilizumab was started on average as third-line biological agent (median, range first- to fourth-line) at a median disease duration of 5.2 years (interquartile range 3.0–7.7). Survival rates were 82% at 12 months and 64% at 24 months. The reasons for discontinuation were inadequate treatment effect in 50%, AE plus inadequate treatment effect in 37.5% and AE alone in 12.5%. LDA (JADAS-10 ⩽3.9) was reached in 58% at 12 months and in 84% at 24 months, inactive disease (JADAS-10 ⩽0.7) in 19% and 44%, and clinically inactive disease in 28% and 46%, respectively. The rate of AEs was 200.9/100 patient years and of serious AEs 12.9/100 patient years.

Conclusion: Survival of tocilizumab was high and a large proportion of the treatment-resistant patients reached LDA at 12 months of treatment. The LDA rate continued to increase throughout 24 months. The rates of AEs and serious AEs were higher than in register studies but lower than in the originator study of tocilizumab.

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Series: Rheumatology
ISSN: 1462-0324
ISSN-E: 1460-2172
ISSN-L: 1462-0324
Volume: 59
Issue: 4
Pages: 732 - 741
DOI: 10.1093/rheumatology/kez291
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This work was supported by Roche Oy.
Copyright information: © The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record Minna-Maija Grönlund, Terhi Remes-Pakarinen, Liisa Kröger, Kati Markula-Patjas, Maria Backström, Anne Putto-Laurila, Kristiina Aalto, Paula Vähäsalo, Efficacy and safety of tocilizumab in a real-life observational cohort of patients with polyarticular juvenile idiopathic arthritis, Rheumatology, kez291, is available online at: