PAIN AND QUALITY OF LFE IMPROVEMENT IN RHEUMATOID ARTHRITIS ON TREATMENT WITH TOCILIZUMAB
P. Athanassiou, E. Devetzi, L. Athanassiou, P. Tsakiridis, M. Gatsiou, A. Tzanavari, I. Kostoglou
Department of Rheumatology, St. Paul’s Hospital, Thessaloniki, Greece
First Department of Internal Medicine, Asclepeion Hospital, Voula, Athens, Greece
Department of Endocrinology, Asclepeion Hospital, Voula, Athens, Greece

Background and aims. Successful management of rheumatoid arthritis (RA) depends on the early administration of DMARDs and biologic DMARDs. Tocilizumab, an interleukin-6 receptor inhibitor, has been used for the management of RA.  The aim was to describe a cohort of RA patients treated with tocilizumab and the effect of this treatment on pain and quality of life.  
Methods. In a cohort of 80 patients with rheumatoid arthritis tocilizumab was administered in combination with methotrexate sc and 10 mg prednisolone. In all patients DAS 28 and VAS were assessed before treatment initiation and 12 months later, 26 patients being on tocilizumab iv 8 mg/kg/4wks and 54 on tocilizumab sc 162mg/wk.  An effort was made to reduce or withdraw corticosteroids and methotrexate. After a year, prednisolone and methotrexate were either significantly reduced or withdrawn.  After a period of 52 weeks 42 of 80 patients (52.5%) were on monotherapy with tocilizumab.   
Results. In a cohort of 80 patients with RA the administration of tocilizumab proved safe and effective. Pain improvement and remission or low disease activity of RA was achieved.  Corticosteroid and methotrexate dosage were reduced.  Six months later disease remission was observed and maintained for 12 months with significant improvement of DAS 28 and VAS (p<0.001, Student’s t test). 
Conclusions. Significant pain improvement and disease remission was observed after 6 months treatment with tocilizumab in RA patients and was maintained for a year.   It appears that tocilizumab is safe and effective for the treatment of RA.