Clinical significance of tocilizumab-related neutropenia in patients with rheumatoid arthritis
Main finding · Grade 3 neutropenia during TCZ treatmentResult — go to the resultHazard ratio 3.120 95% CI 1.189–8.189Authors' conclusion
Approximately 7% of RA patients treated with TCZ developed grade 3 neutropenia. The previous history of neutropenia during csDMARD was a risk factor for TCZ-related neutropenia. Age and extra-articular manifestations, but not neutropenia, were risk factors for infection during TCZ treatment
Study context
- Population
- Rheumatoid arthritis (RA) patients treated with tocilizumab (TCZ) at a tertiary referral hospital in South Korea
- Participants
- 277 patients
- Exposure
- Intravenous vs Subcutaneous
- Intravenousn = 152
- Subcutaneousn = 125
- Outcome
- Risk and clinical significance of TCZ-related neutropenia
Methodological detailssingle-centre, tertiary referral hospital, real-world
- Single-centre
- Tertiary referral hospital
- Real-world
Main finding
Grade 3 neutropenia during TCZ treatment
Hazard ratio
3.120
95% CI 1.189–8.189
P = 0.021
Neutropenia while using csDMARD
HR 3.120 (95% CI 1.189–8.189); P = 0.021
As reported in the abstract
- Grade 3 neutropenia during the observational period
- 22 (7%)
- Discontinued TCZ due to neutropenia
- 0
- csDMARD dosage reduced or discontinued
- 8
Observational data: associations, not effects.
Further findings
Risk factors for infections during TCZ treatment
| Estimate | P value | ||
|---|---|---|---|
| Age over 60 years | HR 2.133 (95% CI 1.118–4.071) | P = 0.022 | |
| Extra-articular manifestations | aHR 11.096 (95% CI 5.353–22.999) | P < 0.001 | |
| Neutropenia | aHR 1.263 (95% CI 0.269–5.945) | P = 0.77 | |
| 0.050.21520Ratio (log scale) |
Safety
Risk factors for infections during TCZ treatment
| Estimate | P value | ||
|---|---|---|---|
| Age over 60 years | HR 2.133 (95% CI 1.118–4.071) | P = 0.022 | |
| Extra-articular manifestations | aHR 11.096 (95% CI 5.353–22.999) | P < 0.001 | |
| Neutropenia | aHR 1.263 (95% CI 0.269–5.945) | P = 0.77 | |
| 0.050.21520Ratio (log scale) |
Pulmonary infections (the most common infections)
- Pulmonary infections
- 10.35 per 100 patient-years
Original publication
Clinical significance of tocilizumab-related neutropenia in patients with rheumatoid arthritis. Joint Bone Spine. Published 13 December 2022. doi:10.
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