factors influencing the use of tocilizumab as monotherapy in patients with rheumatoid arthritis in a real life setting results at 1 year of the act solo study

Rheumatoid arthritis ORIGINAL ARTICLE Factors influencing the use of tocilizumab as monotherapy in patients with rheumatoid arthritis in a real-life setting: results at year of the ACT-SOLO study René-Marc Flipo,1 Jean-Francis Maillefert,2 Pascal Chazerain,3 Isabelle Idier,4 Mathieu Coudert,5 Jacques Tebib6 To cite: Flipo R-M, Maillefert J-F, Chazerain P, et al Factors influencing the use of tocilizumab as monotherapy in patients with rheumatoid arthritis in a reallife setting: results at year of the ACT-SOLO study RMD Open 2017;3:e000340 doi:10.1136/rmdopen-2016000340 ▸ Prepublication history and additional material is available To view please visit the journal (http://dx.doi.org/ 10.1136/rmdopen-2016000340) Received 19 July 2016 Revised 22 November 2016 Accepted December 2016 For numbered affiliations see end of article Correspondence to Dr René-Marc Flipo; Rene-Marc.FLIPO@chru-lille.fr ABSTRACT Introduction: Using a biologic disease-modifying antirheumatic drug (bDMARD) as monotherapy in clinical practice for patients with rheumatoid arthritis (RA) is common and recognised by health authorities although current guidelines recommend to combine them with conventional synthetic (cs)DMARDs This study mainly aimed to search for real-life factors influencing the use of tocilizumab as MONO or in combination (COMBO) Methods: In this non-interventional, prospective, national, multicentre study, data were collected every months over a 12-month period in RA patients starting tocilizumab The proportion of monotherapy patients was described, together with significant explicative factors Results: Among the 577 analysed patients recruited from January 2012 to August 2013 (228 monotherapy patients; 40%), 79% were women, mean RA duration was 11±9 years, previous RA treatments included bDMARDs and csDMARDs in 75% of cases and mean Disease Activity Score 28 joints-Erythrocyte Sedimentation Rate (DAS28-ESR) was 5.2±1.3 at inclusion Explicative factors for monotherapy were at least 65 years (OR=1.47, p=0.0485), no methotrexate within the two last years (OR=5.96, p