Serum granulocyte macrophage-colony stimulating factor (GM-CSF) level is a predictor of treatment response to tocilizumab in rheumatoid arthritis patients: a prospective observational cohort study
Authors' conclusion
The high levels of GM-CSF (> 5 ng/ml and > 10 ng/ml) at baseline were the independent predictors of non-good response and poor response to TCZ at W24 respectively.
Study context
- Population
- Active adult rheumatoid arthritis (RA) patients with inadequate response to MTX intending to receive tocilizumab (TCZ) therapysevere RA
- Participants
- 174 patients
- Exposure
- High vs low baseline serum GM-CSF as predictors of response to TCZ
- Outcome
- Predictors of good response by clinical disease activity index (CDAI) to TCZ
- Follow-up
- Week 24
Main finding
As reported in the abstract
Independent adverse predictors of good response (CDAI) to TCZ · W24
Disease duration, OR
0.996
Tender joint count (TJC)/68, OR
0.943
Neutrophil ratio (W4/baseline), OR
0.224
GM-CSF > 5 ng/ml at baseline, OR
0.414
Observational data: associations, not effects.
Further findings
Non-good response · W24
P = 0.010
Poor response · W24
P = 0.004
Independent predictors of poor response · W24
- DAS28-ESR, OR (P = 0.002)
- 2.951
- GM-CSF > 10 ng/ml at baseline, OR (P = 0.002)
- 5.419
- GM-CSF > 5 ng/ml, OR (P = 0.054; not a predictor)
- 2.713
Baseline characteristics by GM-CSF level and response group
- High GM-CSF group had significantly higher DAS28-ESR and serum IL-17A, IL-1β, IL-6, TNF-α at baseline
- Poor responders had significantly higher GM-CSF, IL-17A and IL-1β at baseline than moderate and good responders; IL-6 and TNF-α not significantly different across three response groups
Original publication
Serum GM-CSF level is a predictor of treatment response to tocilizumab in rheumatoid arthritis patients: a prospective observational cohort study. Arthritis Res Ther. Published 12 July 2024. doi:10.
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