Satisfaction Level of Rheumatoid Arthritis Patients Enrolled in the Treatment with Subcutaneous Tocilizumab

Authors

  • Gucev Filip University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • L.J. Damjanovska-Krstikj University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • D. Antova University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • B. Osmani University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • M. Nikolovska Kotevska University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • A. Karadzova Stojanovska University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • S. Pavlova University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • E. Sandevska University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • M. Bojadzioska University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • S. Vidinik University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • N.G. Jordanovska University Clinic of orthopaedic surgery, Skopje, Republic of North Macedonia
  • I. Kafedjiska University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • G. Bozinovski University Clinic of Rheumatology, Skopje, Republic of North Macedonia
  • S. Perchinkova-Mishevska University Clinic of Rheumatology, Skopje, Republic of North Macedonia

DOI:

https://doi.org/10.12970/2310-9874.2020.08.03

Keywords:

 Rheumatoid arthritis, Tocilizumab-subcutaneous, Tocilizumab intravenous, treatment satisfaction level, patient’s preferences, epidemiological characteristics.

Abstract

Background: The introduction of biological-Disease Modifying Agents (bDMARDs) has allowed serious improvement in the treatment of patients with rheumatoid arthritis (RA) by providing a better quality of life (QoL). Such improvements have been shown in patients using subcutaneous form of Tocilizumab SC (TCZ-SC), a humanized monoclonal antibody against IL-6 receptor.

Objective: To assess the subcutaneous treatment satisfaction level and to evaluate the epidemiological profile of RA patients treated with TCZ-SC in North Macedonian Patients with RA.

Methods: An observational study was conducted at the University Rheumatology Clinic in Skopje between October 1st and December 15th 2018, including 48 patients who have received TCZ-SC. In order to obtain patient’s satisfaction level and to evaluate the epidemiological characteristics of the patients, a standardized questionnaire was developed.

Results: The mean age of the patient’s cohort was 50.9 years and 88.5% of the patients were females. More than half of the patients (58%) had high disease activity with mean disease duration of 5.35 years. Eighty three percent of the patients were entitled to receive subcutaneous TCZ because of the insufficient efficacy of previous treatment, All patients enrolled in the treatment with TCZ-SC, reported to be satisfied or very satisfied with the subcutaneous application of TCZ. They were also very satisfied with the previous education and the opportunity to receive the treatment at home.

Conclusions: Tocilizumab as an efficient and well tolerated bDMARD is becoming a standard of care in the treatment of patients suffering from RA, offering unprecedented benefits for QoL improvement and satisfying the patients’ needs for modern and effective treatment.

References

Rheumatoid Arthritis: National Clinical Guideline for Management and Treatment in Adults. National Collaborating Centre for Chronic Conditions, Royal College of Physicians London UK 2009; 79.

Sokka T, Abelson B, Pincus T. Mortality in rheumatoid arthritis: 2008 update. Clin Exp Rheumatol 2008; 26(51): S35-S61.

Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther 2009; 11(3): 229. https://doi.org/10.1186/ar2669

Arthritis foundation. Treatment of Rheumatoid arthritis. Available at: https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/treatment.php

Gaffo A, Saag KG, Curtis JR. Treatment of Rheumatoid Arthritis. American Journal of Health-System Pharmacy 2006; 63(24): 2451-2465. https://doi.org/10.2146/ajhp050514

Barton J, Patient preferences and satisfaction in the treatment of rheumatoid arthritis with biologic therapy 2009; 3: 335-344. https://doi.org/10.2147/PPA.S5835

Strand V, Burmester GR, Ogale S, Devenport J, John A, Emepy P. Improvements in health-related quality of life after treatment with tocilizumab in patients with rheumatoid arthritis refractory to tumour necrosis factor inhibitors: results from the 24-week randomized controlled RADIATE study, Rheumatology 2012; 51(10): 1860-1869. https://doi.org/10.1093/rheumatology/kes131

European Medical Agency. RoActemra EMA/686079/2018 Available at. https://www.ema.europa.eu/en/medicines/ human/EPAR/roactemra

Kivitz A, Olech E, Borofsky M, et al. Subcutaneous tocilizumab versus placebo in combination with disease-modifying antirheumatic drugs in patients with rheumatoid arthritis. Arthritis Care Res 2014; 66: 1653-61. https://doi.org/10.1002/acr.22384

Gabay C, Emery P, van Vollenhoven R, et al. Tocilizumab monotherapy versus adalimumab monotherapy for treatment of rheumatoid arthritis (ADACTA): a randomised, double-blind, Controlled Phase 4 Trial 2013; 381(9877): 1541-50. https://doi.org/10.1016/S0140-6736(13)60250-0

Lauper K, Mongin D, Iannone F, et al. Comparative effectiveness of subcutaneous tocilizumab versus intravenous tocilizumab in a pan- European collaboration of registries. RMD Open 2018; 4: e000809. https://doi.org/10.1136/rmdopen-2018-000809

Nakashima Y, Kondo M, Miyahara H, Iwamoto Y. Drug delivery options to increase patient adherence and satisfaction in the treatment management of rheumatoid arthritis –focus on subcutaneous tocilizumab. Drug Design Development and Therapy 2014; 8: 913-919. https://doi.org/10.2147/DDDT.S52099

Ogata A, Atsumi T, Fukuda T, et al. Results of switching from intravenous to subcutaneous tocilizumab monotherapy in patients with rheumatoid arthritis: Extension of the MUSASHI study. Arthritis Care & Research 2015; 67(10(10): 1354-1362. https://doi.org/10.1002/acr.22598

Lee SJ, Kremer J, Kavanaugh A. Consortium of Rheumatology Researchers of North America (CORRONA). Treatment disparity related to race/ethnicity and education in rheumatoid arthritis patients: comment on the article by Constantinescu, et al. Arthritis Rheum 2009; 61(8): 1141-1142. https://doi.org/10.1002/art.24727

Aletaha D, Neogi T, Silman AJ, et al. Rheumatoid arthritis classification criteria: An ACR / EULAR collaborative initiative. Arthritis Rheum 2010; 9(62): 2569-2581. https://doi.org/10.1002/art.27584

Burmester G, Rubbert-Roth A, Cantagrel A, et al. Efficacy and safety of subcutaneous tocilizumab versus intravenous tocilizumab in combination with traditional DMARDs in patients with RA at week 97 (SUMMACTA). Ann Rheum Dis 2016; 75: 68-74. https://doi.org/10.1136/annrheumdis-2015-207281

De Mits S, Lenaerts J, Van der Cruyssen B, et al. A nationwide survey on patient’s versus physician’s evaluation of biological therapy in rheumatoid arthritis in relation to disease activity and route of administration. The Be-Raise study. PLoS ONE 2016; 11: e0166607. https://doi.org/10.1371/journal.pone.0166607

Choy E, Caporali R, Xavier R, Fautrel B, Sanmarti R, Bao M, Bernasconi C, Pethö-Schramm A. Subcutaneous tocilizumab in rheumatoid arthritis: findings from the common-framework phase 4 study programme TOZURA conducted in 22 countries. Rheumatology (Oxford) 1; 57(3): 499-507. https://doi.org/10.1093/rheumatology/kex443

Isaacs J, Salih A, Sheeran T. Efficacy and safety of subcutaneous tocilizumab in rheumatoid arthritis over 1 year: a UK real-world, open-label study. Rheumatology Advances in Practice 2019; 0: 1-11. https://doi.org/10.1093/rap/rkz010

Dougados M, Kissel K, Sheeran T, et al. Adding tocilizumab or switching to tocilizumab monotherapy in methotrexate inadequate responders: 24-week symptomatic and structural results of a 2-year randomised controlled strategy trial in rheumatoid arthritis (ACT-RAY). Ann Rheum Dis 2013; 72(1): 43-50. https://doi.org/10.1136/annrheumdis-2011-201282

Besada E. Potential patient benefit of a subcutaneous formulation of tocilizumab for the treatment of rheumatoid arthritis: a critical review. Patient Prefer Adherence 2014; 8: 1051-9. https://doi.org/10.2147/PPA.S34958

McLaughlin M, Östör A. Safety of subcutaneous versus intravenous tocilizumab in combination with traditional disease-modifying antirheumatic drugs in patients with rheumatoid arthritis. Expert Opin Drug Saf 2015; 14(3): 429-37. https://doi.org/10.1517/14740338.2015.998198

Darloy J, Segaud N, Salmon JH, et al. Tocilizumab Effectiveness After Switching from Intravenous to Subcutaneous Route in Patients with Rheumatoid Arthritis: The RoSwitch Study. Rheumatol Ther 2019; 6(1): 61-75. https://doi.org/10.1007/s40744-018-0138-y

Ogata A, Kato Y, Higa S, Yoshizaki K. IL-6 inhibitor for the treatment of rheumatoid arthritis: A comprehensive review. Mod Rheumatol 2019; 29(2): 258-267. https://doi.org/10.1080/14397595.2018.1546357

Desplats M, Pascart T, Jelin G, et al. Are abatacept and tocilizumab intravenous users willing to switch for the subcutaneous route of administration? A questionnaire-based study. Clin Rheumatol 2017; 36(6): 1395-1400. https://doi.org/10.1007/s10067-017-3587-8

Raimondo MG, Biggioggero M, Beccolini A, Crotti C, Favalli EG. Profile of sarilumab and its potential in the treatment of rheumatoid arthritis. Drug Design Development and Therapy 2017; 11: 1593-1603. https://doi.org/10.2147/DDDT.S100302

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Published

2020-04-20

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