Trial Outcomes & Findings for Observational Study of RoActemra/Actemra (Tocilizumab) in Patients With Rheumatoid Arthritis (NCT NCT01579006)

NCT ID: NCT01579006

Last Updated: 2016-03-07

Results Overview

Recruitment status

COMPLETED

Target enrollment

184 participants

Primary outcome timeframe

6 months

Results posted on

2016-03-07

Participant Flow

Participant milestones

Participant milestones
Measure
Rheumatoid Arthritis Participants
Participants with moderate to severe rheumatoid arthritis (RA), according to the American College of Rheumatology (ACR) criteria and the Disease Activity Score Based on 28 Joints (DAS28), who have had an inadequate response (or were intolerant) to treatment with non-biological disease-modifying anti-rheumatic drugs (DMARDs) or with one biological agent in whom the attending physician decided to start treatment with tocilizumab (TCZ) (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Overall Study
STARTED
184
Overall Study
COMPLETED
151
Overall Study
NOT COMPLETED
33

Reasons for withdrawal

Reasons for withdrawal
Measure
Rheumatoid Arthritis Participants
Participants with moderate to severe rheumatoid arthritis (RA), according to the American College of Rheumatology (ACR) criteria and the Disease Activity Score Based on 28 Joints (DAS28), who have had an inadequate response (or were intolerant) to treatment with non-biological disease-modifying anti-rheumatic drugs (DMARDs) or with one biological agent in whom the attending physician decided to start treatment with tocilizumab (TCZ) (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Overall Study
Lack of Efficacy
10
Overall Study
Adverse Event
13
Overall Study
Withdrawal by Subject
5
Overall Study
Non-compliance
3
Overall Study
Due to participant's health fund
1
Overall Study
Scheduled surgery
1

Baseline Characteristics

Observational Study of RoActemra/Actemra (Tocilizumab) in Patients With Rheumatoid Arthritis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Age, Continuous
54.8 years
STANDARD_DEVIATION 13.7 • n=5 Participants
Sex: Female, Male
Female
141 Participants
n=5 Participants
Sex: Female, Male
Male
43 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 6 months

Population: FAS population

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants on TCZ Treatment at 6 Months After Treatment Initiation
42.4 percentage of participants
Interval 35.1542 to 49.8776

PRIMARY outcome

Timeframe: 5-6 months

Population: FAS population

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants on TCZ Treatment at 5-6 Months After Treatment Initiation
85.9 percentage of participants
Interval 79.985 to 90.5573

SECONDARY outcome

Timeframe: Baseline

Population: FAS population.

Systemic manifestations included fibromyalgia, osteoporosis, sjogren's syndrome, anemia, rheumatoid nodules, pulmonary fibrosis, vasculitis, peripheral neuropathy or mononeuropathy, scleritis, episcleritis, hypertension, hyperlipidemia, low high-density lipoproteins, diabetes type 1 and type 2, metabolic syndrome, carotid artery disease, transient ischemic attacks, embolic stroke, atherothrombotic stroke, atrial fibrillation, heart failure New York Heart Association (NYHA) Class l/ll, coronary heart disease(angina pectoris/myocardial), aortic aneurism, peripheral arterial occlusive disease, percutaneous coronary interventions, coronary artery bypass, carotid endarterectomy and peripheral arterial bypass.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants With Systemic Manifestations of RA at Baseline
Fibromyalgia
8.7 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Osteoporosis
22.3 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Sjogren's syndrome
6.5 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Anemia
21.8 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Rheumatoid nodules
8.1 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Pulmonary fibrosis
3.2 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Vasculitis
0.5 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Peripheral neuropathy or mononeuropathy
4.3 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Scleritis
1.6 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Episcleritis
0.5 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Hypertension
32.1 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Hyperlipidemia
38.0 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Low high-density lipoproteins
8.7 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Diabetes type 1 and type 2
15.2 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Metabolic syndrome
10.3 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Carotid artery disease
1.1 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Transient ischemic attacks
3.3 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Embolic stroke
0.5 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Atherothrombotic stroke
2.7 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Atrial fibrillation
1.1 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Heart Failure NYHA class l/ll
1.6 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Coronary heart disease(angina pectoris/myocardial)
6.0 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Aortic aneurism
0.5 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Peripheral arterial occlusive disease
0.5 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Percutaneous coronary interventions
4.4 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Coronary artery bypass
1.6 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Carotid Endarterectomy
0.5 percentage of participants
Percentage of Participants With Systemic Manifestations of RA at Baseline
Peripheral arterial bypass
2.1 percentage of participants

SECONDARY outcome

Timeframe: Prior to study start (8 weeks) and Baseline up to 6 months

Population: FAS population.

DMARDs exposure was evaluated for all participants. "Prior DMARDs treatment" included participants, who were treated with DMARDs 8 weeks and according to physician's discretion before being included in the study. "DMARDs treatment at baseline" included participants who were receiving DMARDs when they were included in the study and continued with this concomitant medication in addition to TCZ. Only those participants who received DMARDs prior to start of study and at Baseline up to 6 months were reported.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Leflunomide: Adm 1 to 6
25.0 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Azathioprine: Prior to study
0.6 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Gold Compounds: Prior to study
2.2 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Hydroxychloroquine: Prior to study
33.3 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Leflunomide: Prior to study
7.9 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Methotrexate: Prior to study
24.5 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Sulfasalazine: Prior to study
29.2 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Other DMARD: Prior to study
2.2 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Azathioprine: Adm 1 to 6
1.1 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Gold Compounds: Adm 1 to 6
3.3 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Hydroxychloroquine: Adm 1 to 6
84.8 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Methotrexate: Adm 1 to 6
96.2 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Other DMARD: Adm 1 to 6
20.7 percentage of participants
Percentage of Participants Who Received DMARDs Prior to Start of Study and Concomitantly With TCZ During the Study
Sulfasalazine: Adm 1 to 6
69.0 percentage of participants

SECONDARY outcome

Timeframe: Up to 6 months

Population: FAS population.

Objective intolerance was determined by medical observation; subjective intolerance was determined by the participant; lack of efficacy was determined by physician discretion.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants With Reason for DMARD Withdrawal
Methotrexate: Lack of efficacy
27.3 percentage of participants
Interval 19.217 to 36.5911
Percentage of Participants With Reason for DMARD Withdrawal
Methotrexate: Intolerance,Objective
22.7 percentage of participants
Interval 15.2801 to 31.6955
Percentage of Participants With Reason for DMARD Withdrawal
Methotrexate: Intolerance,Subjective
17.3 percentage of participants
Interval 10.7316 to 25.652
Percentage of Participants With Reason for DMARD Withdrawal
Methotrexate: Other
32.7 percentage of participants
Interval 24.0832 to 42.3279
Percentage of Participants With Reason for DMARD Withdrawal
Hydroxychloroquine: Lack of efficacy
60.0 percentage of participants
Interval 50.4498 to 69.0222
Percentage of Participants With Reason for DMARD Withdrawal
Hydroxychloroquine: Intolerance,Objective
14.8 percentage of participants
Interval 8.8536 to 22.6102
Percentage of Participants With Reason for DMARD Withdrawal
Hydroxychloroquine: Intolerance,Subjective
12.2 percentage of participants
Interval 6.8181 to 19.5816
Percentage of Participants With Reason for DMARD Withdrawal
Hydroxychloroquine: Other
13.0 percentage of participants
Interval 7.4878 to 20.5993
Percentage of Participants With Reason for DMARD Withdrawal
Sulfasalazine: Lack of efficacy
60.6 percentage of participants
Interval 50.7331 to 69.7795
Percentage of Participants With Reason for DMARD Withdrawal
Sulfasalazine: Intolerance,Objective
11.9 percentage of participants
Interval 6.5057 to 19.5311
Percentage of Participants With Reason for DMARD Withdrawal
Sulfasalazine: Intolerance,Subjective
9.2 percentage of participants
Interval 4.4876 to 16.2252
Percentage of Participants With Reason for DMARD Withdrawal
Sulfasalazine: Other
18.3 percentage of participants
Interval 11.5831 to 26.9055
Percentage of Participants With Reason for DMARD Withdrawal
Leflunomide: Lack of efficacy
63.2 percentage of participants
Interval 45.9943 to 78.1875
Percentage of Participants With Reason for DMARD Withdrawal
Leflunomide: Intolerance,Objective
5.3 percentage of participants
Interval 0.6439 to 17.7491
Percentage of Participants With Reason for DMARD Withdrawal
Leflunomide: Intolerance,Subjective
10.5 percentage of participants
Interval 2.9435 to 24.8049
Percentage of Participants With Reason for DMARD Withdrawal
Leflunomide: Other
21.1 percentage of participants
Interval 9.5541 to 37.3188
Percentage of Participants With Reason for DMARD Withdrawal
Gold compounds: Lack of efficacy
100 percentage of participants
Interval 66.3733 to 100.0
Percentage of Participants With Reason for DMARD Withdrawal
Azathioprine: Lack of efficacy
66.7 percentage of participants
Interval 9.4299 to 99.1596
Percentage of Participants With Reason for DMARD Withdrawal
Azathioprine: Intolerance, Subjective
33.3 percentage of participants
Interval 0.8404 to 90.5701
Percentage of Participants With Reason for DMARD Withdrawal
Other: Lack of efficacy
44.0 percentage of participants
Interval 24.4024 to 65.0718
Percentage of Participants With Reason for DMARD Withdrawal
Other: Intolerance,Objective
8.0 percentage of participants
Interval 0.984 to 26.0306
Percentage of Participants With Reason for DMARD Withdrawal
Other: Intolerance,Subjective
16.0 percentage of participants
Interval 4.5379 to 36.0828
Percentage of Participants With Reason for DMARD Withdrawal
Other: Unspecified
32.0 percentage of participants
Interval 14.9495 to 53.5001

SECONDARY outcome

Timeframe: Prior to study start (8 weeks)

Population: FAS population.

Biological RA treatment exposure was evaluated for all participants. "Prior biological RA treatment" included participants who were treated with biological RA treatment 8 weeks before being included in the study. Percentage of participants who did not receive any biological RA treatment and percentage of participants who received one or more biologic RA treatments were reported.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants Who Received Biological RA Treatment Prior to Start of Study
Did not receive any biologic RA treatment
53.8 percentage of participants
Percentage of Participants Who Received Biological RA Treatment Prior to Start of Study
Received 1 biologic RA treatment
38.6 percentage of participants
Percentage of Participants Who Received Biological RA Treatment Prior to Start of Study
Received 2 biologic RA treatments
7.1 percentage of participants
Percentage of Participants Who Received Biological RA Treatment Prior to Start of Study
Received 3 or more biologic RA treatments
0.5 percentage of participants

SECONDARY outcome

Timeframe: Up to 6 months

Population: FAS population.

Previous biologic RA treatment included adalimumab, infliximab, golimumab, etanercept, certolizumab, and other (any other previous biologic RA treatment). Same participants may be counted in more than one previous biologic RA treatment category.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants With Type of Previous Biologic RA Treatments
Adalimumab
15.2 percentage of participants
Percentage of Participants With Type of Previous Biologic RA Treatments
Infliximab
8.2 percentage of participants
Percentage of Participants With Type of Previous Biologic RA Treatments
Golimumab
4.3 percentage of participants
Percentage of Participants With Type of Previous Biologic RA Treatments
Etanercept
17.4 percentage of participants
Percentage of Participants With Type of Previous Biologic RA Treatments
Certolizumab
1.6 percentage of participants
Percentage of Participants With Type of Previous Biologic RA Treatments
Other
7.6 percentage of participants

SECONDARY outcome

Timeframe: Up to 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure and "n"= participants who were evaluable for each category.

Previous biologic RA treatment included adalimumab, infliximab, golimumab, etanercept, certolizumab, and other (any other previous biologic RA treatment).

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=85 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Duration of Previous Biologic RA Treatments
Infliximab (n=14)
2.5 years
Standard Deviation 2.9
Duration of Previous Biologic RA Treatments
Golimumab (n=8)
1.6 years
Standard Deviation 0.8
Duration of Previous Biologic RA Treatments
Etanercept (n=31)
1.7 years
Standard Deviation 1.9
Duration of Previous Biologic RA Treatments
Certolizumab (n=3)
4.9 years
Standard Deviation 1.9
Duration of Previous Biologic RA Treatments
Other (n=13)
1.4 years
Standard Deviation 2.2
Duration of Previous Biologic RA Treatments
Adalimumab (n=27)
0.9 years
Standard Deviation 1.0

SECONDARY outcome

Timeframe: Up to 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure and "n"= participants who were evaluable for each category.

Lack of efficacy was determined by physician discretion. Previous biologic RA treatment included adalimumab, infliximab, golimumab, etanercept, certolizumab, and other (any other previous biologic RA treatment).

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Adalimumab: Lack of efficacy (n=28)
85.7 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Adalimumab: Adverse event (n=28)
10.7 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Adalimumab: Other (n=28)
3.6 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Infliximab: Lack of efficacy (n=15)
53.3 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Infliximab: Adverse event (n=15)
26.7 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Infliximab: Other (n=15)
20.0 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Golimumab: Lack of efficacy (n=8)
62.5 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Golimumab: Adverse event (n=8)
25.0 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Golimumab: Other (n=8)
12.5 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Etanercept: Lack of efficacy (n=31)
67.7 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Etanercept: Adverse event (n=31)
19.4 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Etanercept: Other (n=31)
12.9 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Certolizumab: Lack of efficacy (n=3)
33.3 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Certolizumab: Adverse event (n=3)
33.3 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Certolizumab: Other (n=3)
33.3 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Other: Lack of efficacy (n=13)
53.8 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Other: Adverse event (n=13)
15.4 percentage of participants
Percentage of Participants With Reasons for Termination of Previous Biologic RA Treatments
Other: Unspecified (n=13)
30.8 percentage of participants

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure and "n"= participants who were evaluable for each category.

TCZ was administered every 4 weeks according to the label. Due to the observational nature of the study, the suggested schedule was subject to changes according to physician and participant considerations.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=183 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants With Dose Modifications
TCZ Administration 1 (Baseline) (n=183)
0.0 percentage of participants
Interval 0.0 to 1.9956
Percentage of Participants With Dose Modifications
TCZ Administration 2 (Week 4) (n=178)
2.8 percentage of participants
Interval 0.9182 to 6.4332
Percentage of Participants With Dose Modifications
TCZ Administration 3 (Week 8) (n=174)
2.3 percentage of participants
Interval 0.6298 to 5.7811
Percentage of Participants With Dose Modifications
TCZ Administration 4 (Week 12) (n=166)
1.8 percentage of participants
Interval 0.3743 to 5.1904
Percentage of Participants With Dose Modifications
TCZ Administration 5 (Week 16) (n=158)
1.9 percentage of participants
Interval 0.3933 to 5.4484
Percentage of Participants With Dose Modifications
TCZ Administration 6 (Week 20) (n=151)
3.3 percentage of participants
Interval 1.0837 to 7.558

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

TCZ was administered every 4 weeks according to the label. Due to the observational nature of the study, the suggested schedule was subject to changes according to physician and participant considerations. Only those participants who had dose modifications were reported.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=20 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants With Reasons for Dose Modification
TCZ Administration 2 (Week 4):Adverse event/safety
80.0 percentage of participants
Interval 28.3582 to 99.4949
Percentage of Participants With Reasons for Dose Modification
TCZ Administration 2 (Week 4):Other reason
20.0 percentage of participants
Interval 0.5051 to 71.6418
Percentage of Participants With Reasons for Dose Modification
TCZ Administration 3 (Week 8):Adverse event/safety
100.0 percentage of participants
Interval 39.7635 to 100.0
Percentage of Participants With Reasons for Dose Modification
TCZ Administration 4(Week 12):Adverse event/safety
66.7 percentage of participants
Interval 9.4299 to 99.1596
Percentage of Participants With Reasons for Dose Modification
TCZ Administration 4 (Week 12): Other reason
33.3 percentage of participants
Interval 0.8404 to 90.5701
Percentage of Participants With Reasons for Dose Modification
TCZ Administration 5(Week 16):Adverse event/safety
100.0 percentage of participants
Interval 29.2402 to 100.0
Percentage of Participants With Reasons for Dose Modification
TCZ Administration 6(Week 20):Adverse event/safety
40.0 percentage of participants
Interval 5.2745 to 85.3367
Percentage of Participants With Reasons for Dose Modification
TCZ Administration 6 (Week 20): Other reason
60.0 percentage of participants
Interval 14.6633 to 94.7255

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure and "n"= participants who were evaluable for each category.

TCZ was administered every 4 weeks according to the label. Due to the observational nature of the study, the suggested schedule was subject to changes according to physician and participant considerations.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=182 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Mean Dose at 6 Months
TCZ Administration 1 (Baseline) (n=182)
8.0 milligrams per kilogram (mg/kg)
Standard Deviation 0.0
Mean Dose at 6 Months
TCZ Administration 2 (Week 4) (n=179)
7.9 milligrams per kilogram (mg/kg)
Standard Deviation 0.6
Mean Dose at 6 Months
TCZ Administration 3 (Week 8) (n=174)
7.9 milligrams per kilogram (mg/kg)
Standard Deviation 0.6
Mean Dose at 6 Months
TCZ Administration 4 (Week 12) (n=166)
7.9 milligrams per kilogram (mg/kg)
Standard Deviation 0.5
Mean Dose at 6 Months
TCZ Administration 5 (Week 16) (n=158)
7.9 milligrams per kilogram (mg/kg)
Standard Deviation 0.3
Mean Dose at 6 Months
TCZ Administration 6 (Week 20) (n=151)
7.9 milligrams per kilogram (mg/kg)
Standard Deviation 0.5

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

TCZ was administered every 4 weeks according to the label. Due to the observational nature of the study, the suggested schedule was subject to changes according to physician and participant considerations.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=12 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Mean Number of Dose Modifications at 6 Months
1.7 dose modification
Standard Deviation 0.9

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure and "n"= participants who were evaluable for each category.

TCZ was administered every 4 weeks according to the label. Due to the observational nature of the study, the suggested schedule was subject to changes according to physician and participant considerations. The mean dosing interval between different TCZ administrations (Adm) by participants within 6 months observational period was presented.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=178 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Mean Dosing Interval of Treatment at 6 Months
Between TCZ Adm 1 (Baseline) and 2 (Week 4)(n=178)
31.4 days
Standard Deviation 5.7
Mean Dosing Interval of Treatment at 6 Months
Between TCZ Adm 2 (Week 4) and 3 (Week 8) (n=174)
30.8 days
Standard Deviation 4.5
Mean Dosing Interval of Treatment at 6 Months
Between TCZ Adm 3 (Week 8) and 4 (Week 12) (n=166)
31.4 days
Standard Deviation 4.7
Mean Dosing Interval of Treatment at 6 Months
Between TCZ Adm 4 (Week 12) and 5 (Week 16)(n=158)
31.8 days
Standard Deviation 7.2
Mean Dosing Interval of Treatment at 6 Months
Between TCZ Adm 5 (Week 16) and 6 (Week 20)(n=150)
31.9 days
Standard Deviation 8.6

SECONDARY outcome

Timeframe: 6 months

Population: FAS population.

The safety variable measured the number of participants who discontinued TCZ due to adverse reactions to TCZ, and the efficacy variable measured the participants who discontinued from TCZ due to lack of efficacy according to criteria of the treating physician.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants Who Discontinued From TCZ for Safety Versus Efficacy
Lack of efficacy
6.0 percentage of participants
Interval 3.0218 to 10.4448
Percentage of Participants Who Discontinued From TCZ for Safety Versus Efficacy
Adverse event
6.5 percentage of participants
Interval 3.415 to 11.115
Percentage of Participants Who Discontinued From TCZ for Safety Versus Efficacy
Other
5.4 percentage of participants
Interval 2.6366 to 9.7675

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=7 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Time to Restoration of Initial Dosing Regimen
81.6 days
Standard Deviation 34.9

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

A participant's adherence was calculated based on the adverse event or laboratory abnormality experienced by the participants who required dose modifications as per local TCZ label or protocol.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=15 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants Who Adhered to the Dosing Regimen Recommended by Physician
8.2 percentage of participants
Interval 4.6345 to 13.0893

SECONDARY outcome

Timeframe: Up to 6 months

Population: FAS population. Here, "n"= participants who were evaluable for each category.

TCZ was administered every 4 weeks according to the label. Due to the observational nature of the study, the suggested schedule was subject to changes according to physician and participant considerations. Only those participants who had TCZ as monotherapy were reported.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=184 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants on TCZ Monotherapy
TCZ Administration 1 (Baseline) (n=184)
32.6 percentage of participants
Interval 25.8944 to 39.894
Percentage of Participants on TCZ Monotherapy
TCZ Administration 2 (Week 4) (n=178)
34.3 percentage of participants
Interval 27.3324 to 41.7408
Percentage of Participants on TCZ Monotherapy
TCZ Administration 3 (Week 8) (n=174)
35.6 percentage of participants
Interval 28.53 to 43.2332
Percentage of Participants on TCZ Monotherapy
TCZ Administration 4 (Week 12) (n=166)
38.0 percentage of participants
Interval 30.5448 to 45.7972
Percentage of Participants on TCZ Monotherapy
TCZ Administration 5 (Week 16) (n=158)
38.6 percentage of participants
Interval 30.9797 to 46.6713
Percentage of Participants on TCZ Monotherapy
TCZ Administration 6 (Week 20) (n=151)
41.7 percentage of participants
Interval 33.7596 to 50.0155

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants with valid data to calculate TJC at the end of study (6 months).

The number of tender joints was recorded on the joint assessment form, with no tenderness = 0, and tenderness = 1, for 68 joints, giving a total possible TJC score of 0 to 68.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=67 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in Tender Joint Count (TJC) (68 Joints) at Month 6
-10.7 Tender Joint Count
Standard Deviation 10.3

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

The number of swollen joints was recorded on the joint assessment form, with no swelling = 0, and swelling =1, for 66 joints, giving a total possible SJC score of 0 to 66.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=67 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in Swollen Joint Count (SJC) (66 Joints) at Month 6
-6.7 Swollen Joint Count
Standard Deviation 7.5

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

DAS28 was calculated from SJC and TJC using an assessment of 28 joints, the erythrocyte sedimentation rate (ESR) (milliliter per hour \[mm/hr\]), and Patient's Global Assessment (PGH) of disease activity (measured on a 0 to 100 mm Visual Analogue Scale \[VAS\] where 0=no disease activity and 100=worst disease activity). DAS28 was calculated using the following formula: DAS28 = 0.56\*square root (sqrt) (TJC28) + 0.28\*sqrt(SJC28) + 0.70\*natural logarithm (ln) (ESR) + 0.014\*PGH of disease activity. Total score range: 0-10, with a higher score indicated more disease activity. DAS28 \<=3.2 implied low disease activity, DAS \>3.2 to 5.1 implied moderate disease activity and DAS \>5.1 implied high disease activity, and DAS28 \<2.6 = clinical remission.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=46 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in Disease Activity Score Based on 28 Joints (DAS28) at Month 6
-2.7 Score on a scale
Standard Deviation 1.7

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

Clinical response assessed as per EULAR categorical DAS28 response criteria was defined as clinically meaningful improvement at a particular time point. EULAR response was based on change from baseline (CFB) in the DAS28 score and also on the actual DAS28 score at the time point so was more reflective of the current status of the participant. The DAS28 score was a measure of the participant's disease activity, based on the TJC (28 joints), SJC (28 joints), PGH (mm), and ESR (mm/hr). DAS28 total scores ranged from 0 to approximately 10. Scores \<2.6 = best disease control and scores \>5.1 = worse disease control. A negative CFB indicated clinically meaningful improvement. EULAR Good response: DAS28 \<=3.2 and a CFB \<-1.2. EULAR Moderate response: DAS28 \>3.2 to ≤ 5.1 or a CFB \< -0.6 to ≥ -1.2. EULAR No response: DAS28 ≤3.2 or CFB \>=-0.6, DAS28 \>3.2 to \<=5.1 or CFB \>=-0.6 and DAS28 \>5.1 or CFB \>=-0.6.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=46 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants With European League Against Rheumatism (EULAR) Response at Month 6
Good
56.5 percentage of participants
Interval 41.1071 to 71.0657
Percentage of Participants With European League Against Rheumatism (EULAR) Response at Month 6
Moderate
28.3 percentage of participants
Interval 15.9867 to 43.4604
Percentage of Participants With European League Against Rheumatism (EULAR) Response at Month 6
No response
15.2 percentage of participants
Interval 6.3444 to 28.8691

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

The SDAI was a combined index for measuring disease activity in RA which reflected the numerical sum of five outcome parameters: TJC and SJC based on a 28-joint assessment, PGH and physician's global assessment (PhGH) of disease activity, assessed on 0-100 mm VAS where 0 = no disease activity and 100 = worst disease activity, and C-reactive protein (CRP) (milligrams per deciliter \[mg/dL\]). SDAI total score = 0-86. A SDAI score of \<=3.3 represented clinical remission, a score of \<=11.0 represents low disease activity, a score of \<=26.0 represented moderate disease activity and a score of \>26.0 represented high (or severe) disease.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=52 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in Simplified Disease Activity Index (SDAI) Score at Month 6
-18.7 Score on a scale
Standard Deviation 16.7

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

The CDAI was a combined index for measuring disease activity in RA and used to evaluate disease activity in the absence of laboratory testing of CRP and ESR. It was the numerical sum of 4 outcome parameters: TJC and SJC based on a 28-joint assessment, PGH and PhGH (assessed on 0-100 mm); VAS (0 = no disease activity and 100 = worst disease activity). CDAI total score = 0-76. A CDAI score of \<=2.8 represented clinical remission, a score of \<=10.0 represented low disease activity, a score of \<=22.0 represented moderate disease activity and a score of \>22.0 represented high (or severe) disease.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=70 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in Clinical Disease Activity Index (CDAI) Score at Month 6
-17.3 Score on a scale
Standard Deviation 15.2

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

ACR response was calculated based on total joint count evaluation (28 or 66/68 joint count) and other clinical and laboratory assessments. A positive ACR20 response required at least a 20% improvement (reduction) compared to baseline in swollen joint count (66 joints) and tender joint count (68 joints) and at least 3 of the following 5 assessments: participant's global assessment of pain, PGH, PhGH (all 3 assessed at 0 \[good\] to 100 mm \[worst\] VAS scale), participant assessment of disability measured by the Health Assessment Questionnaire-Disability Index (HAQ-DI) (assessed on a 0 to 3 scale, where higher scores represented higher disease activity), Acute phase reactant (CRP or ESR). A reduction in the level of and acute phase reactants was considered an improvement.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=31 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants Who Achieved 20% Improvement in ACR (ACR20) Response at Month 6
54.8 percentage of participants

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

ACR response was calculated based on total joint count evaluation (28 or 66/68 joint count) and other clinical and laboratory assessments. A positive ACR50 response required at least a 50% improvement (reduction) compared to baseline in swollen joint count (66 joints) and tender joint count (68 joints) and at least 3 of the following 5 assessments: (participant's global assessment of pain, PGH, PhGH (all 3 assessed at 0 \[good\] to 100 mm \[worst\] VAS scale), participant assessment of disability measured by the Health Assessment Questionnaire-Disability Index (HAQ-DI) (assessed on a 0 to 3 scale, where higher scores represented higher disease activity), and acute phase reactant (CRP or ESR). A reduction in the level of acute phase reactants was considered an improvement.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=31 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants Who Achieved 50% Improvement in ACR (ACR50) Response at Month 6
32.3 percentage of participants

SECONDARY outcome

Timeframe: 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

ACR response was calculated based on total joint count evaluation (28 or 66/68 joint count) and other clinical and laboratory assessments. A positive ACR70 response required at least a 70% improvement (reduction) compared to baseline in swollen joint count (66 joints) and tender joint count (68 joints) and at least 3 of the following 5 assessments: (participant's global assessment of pain, PGH, PhGH (all 3 assessed at 0 \[good\] to 100 mm \[worst\] VAS scale), participant assessment of disability measured by the Health Assessment Questionnaire-Disability Index (HAQ-DI) (assessed on a 0 to 3 scale, where higher scores represented higher disease activity), and acute phase reactant (CRP or ESR). A reduction in the level of acute phase reactants was considered an improvement.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=31 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Percentage of Participants Who Achieved 70% Improvement in ACR (ACR70) Response at Month 6
9.7 percentage of participants

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

The test for CRP was a laboratory measurement for evaluation of an acute phase reactant of inflammation through the use of an ultrasensitive assay. The serum concentration of CRP was measured in mg/dL. A reduction in the level was considered an improvement.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=55 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in CRP at Month 6
-1.6 mg/dL
Standard Deviation 2.5

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

ESR was a laboratory test that provided a non-specific measure of inflammation. The test assessed the rate at which red blood cells fell in a test tube. ESR was measured in mm/hr. A reduction in the level was considered an improvement.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=49 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in ESR at Month 6
-34.4 mm/hr
Standard Deviation 26.1

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

The PhGH was assessed using a 0 to 100 mm horizontal VAS by the physician. The left-hand extreme of the line equaled 0 mm, and was described as "no disease activity" (symptom-free and no arthritis symptoms) and the right-hand extreme equaled 100 mm, as "maximum disease activity" (maximum arthritis disease activity). A negative change from baseline indicated improvement.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=72 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in PhGH at Month 6
-34.0 mm
Standard Deviation 28.2

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

The PGH of disease activity was assessed using a 0 to 100 mm horizontal VAS by the participant. The left-hand extreme of the line equaled 0 mm, and was described as "no disease activity" (symptom-free and no arthritis symptoms) and the right-hand extreme equaled 100 mm, as "maximum disease activity" (maximum arthritis disease activity). A negative change from baseline indicated improvement.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=75 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in PGH of Disease Activity at Month 6
-26.5 mm
Standard Deviation 28.4

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: ITT population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

The HAQ-DI was a participant self-reported questionnaire for assessing the extent of a participant's functional ability. It consisted of 20 questions in 8 categories (dressing and grooming, rising, eating, walking, reach, grip, hygiene, and carrying out daily activities). Each question had 4 response options, ranging from "no difficulty" to "unable to do", corresponding to scores from 0 to 3. The HAQ-DI scale was an average of all the scores and ranged from 0 to 3, where higher scores represented higher disease activity. A score of \<0.5 represented clinical remission. A participant achieved a clinically meaningful improvement in HAQ-DI if they had a reduction from baseline of \>=0.22.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=77 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in HAQ-DI at Month 6
-0.3 Score on a scale
Standard Deviation 0.7

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

Fatigue was evaluated by a VAS. Participants marked on a 100 mm horizontal VAS the level of fatigue that they have experienced, ranging from 0 (no fatigue) to 100 (extreme fatigue).

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=74 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in Participant's Assessment of Fatigue Using VAS at Month 6
-17.9 mm
Standard Deviation 31.1

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

Severity of pain was evaluated by a VAS. Participants marked on a 100 mm horizontal VAS the severity of pain that they had experienced because of their RA, ranging from 0 (no pain) to 100 (unbearable pain). A decrease of 10 points was considered clinically meaningful.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=76 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in Participant's Assessment of RA-Related Pain at Month 6
-23.7 mm
Standard Deviation 32.6

SECONDARY outcome

Timeframe: Administration 1 (Baseline), 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure and "n"= participants who were evaluable for each category.

The FACIT Measurement System was a collection of health-related quality of life questionnaires targeted to the management of chronic illness and included questions on Physical Well-Being, Social/Family Well-Being, Emotional Well-Being and Functional Well-Being. The FACIT Fatigue Scale was a 13-item tool that measured an individual's level of fatigue during their usual daily activities over the past week. The level of fatigue was measured on a five-point Likert scale (4 = not at all fatigued to 0 = very much fatigued). The total score of FACIT ranged from 0 to 160. An increase of 4 points in the FACIT-Fatigue score was considered clinically meaningful. Change from Administration 1 was reported for individual administration schedules. TCZ was administered every 4 weeks according to the label. Due to the observational nature of the study, the suggested schedule was subject to changes according to physician and participant considerations.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=55 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Administration 1 in Functional Assessment of Chronic Illness Therapy (FACIT)- Fatigue Questionnaire at Month 6
Change at Administration 2 (n=38)
7.3 Score on a scale
Standard Deviation 12.7
Change From Administration 1 in Functional Assessment of Chronic Illness Therapy (FACIT)- Fatigue Questionnaire at Month 6
Change at Administration 3 (n=39)
11.7 Score on a scale
Standard Deviation 18.1
Change From Administration 1 in Functional Assessment of Chronic Illness Therapy (FACIT)- Fatigue Questionnaire at Month 6
Change at Administration 4 (n=35)
11.9 Score on a scale
Standard Deviation 18.3
Change From Administration 1 in Functional Assessment of Chronic Illness Therapy (FACIT)- Fatigue Questionnaire at Month 6
Change at Administration 5 (n=31)
17.3 Score on a scale
Standard Deviation 20.5
Change From Administration 1 in Functional Assessment of Chronic Illness Therapy (FACIT)- Fatigue Questionnaire at Month 6
Change at Administration 6 (n=33)
20.0 Score on a scale
Standard Deviation 23.9

SECONDARY outcome

Timeframe: Baseline, 6 months

Population: FAS population. Here, number of participants analyzed = participants who were evaluable for this outcome measure.

Morning stiffness was defined by the time elapsed between the time of usual awakening (even if not in the morning) and the time the participant was as limber as he/she would be during a day involving typical activities. Morning stiffness was assessed on a 100 mm VAS, where 0= none and 100= very severe.

Outcome measures

Outcome measures
Measure
Rheumatoid Arthritis Participants
n=76 Participants
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who have had an inadequate response (or were intolerant) to treatment with non-biological DMARDs or with one biological agent in whom the attending physician decided to start treatment with TCZ (according to local label) at the time of recruitment or up to 8 week prior to the time of recruitment were observed for 6 months.
Change From Baseline in Morning Stiffness as Assessed Using VAS at Month 6
-26.6 mm
Standard Deviation 34.9

Adverse Events

Rheumatoid Arthritis Participants

Serious events: 17 serious events
Other events: 77 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Rheumatoid Arthritis Participants
n=184 participants at risk
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who had been receiving TCZ in the past and in whom the attending physician decided to start treatment with TCZ at the time of recruitment (according to the local label) were observed for 6 months.
Blood and lymphatic system disorders
Microcytic anaemia
0.54%
1/184 • Up to 6 months
Blood and lymphatic system disorders
Pancytopenia
1.1%
2/184 • Up to 6 months
Cardiac disorders
Acute myocardial infarction
1.1%
2/184 • Up to 6 months
Cardiac disorders
Sinus tachycardia
0.54%
1/184 • Up to 6 months
Gastrointestinal disorders
Upper abdominal pain
0.54%
1/184 • Up to 6 months
General disorders
Asthenia
0.54%
1/184 • Up to 6 months
General disorders
Chest pain
0.54%
1/184 • Up to 6 months
Infections and infestations
Pneumonia
0.54%
1/184 • Up to 6 months
Infections and infestations
Post procedural sepsis
0.54%
1/184 • Up to 6 months
Infections and infestations
Upper respiratory tract infection
1.6%
3/184 • Up to 6 months
Infections and infestations
Urinary tract infection
0.54%
1/184 • Up to 6 months
Injury, poisoning and procedural complications
Overdose
0.54%
1/184 • Up to 6 months
Metabolism and nutrition disorders
Hypercalcaemia
0.54%
1/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Arthralgia
1.1%
2/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Osteoporotic fracture
0.54%
1/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Pain in extremity
0.54%
1/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Rheumatoid arthritis
1.1%
2/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Spinal column stenosis
0.54%
1/184 • Up to 6 months
Nervous system disorders
Cerebrovascular accident
0.54%
1/184 • Up to 6 months
Renal and urinary disorders
Nephrolithiasis
0.54%
1/184 • Up to 6 months
Renal and urinary disorders
Acute renal failure
0.54%
1/184 • Up to 6 months

Other adverse events

Other adverse events
Measure
Rheumatoid Arthritis Participants
n=184 participants at risk
Participants with moderate to severe RA, according to the ACR criteria and the DAS28, who had been receiving TCZ in the past and in whom the attending physician decided to start treatment with TCZ at the time of recruitment (according to the local label) were observed for 6 months.
Blood and lymphatic system disorders
Anaemia
1.6%
3/184 • Up to 6 months
Blood and lymphatic system disorders
Leukopenia
2.7%
5/184 • Up to 6 months
Blood and lymphatic system disorders
Lymphocytosis
0.54%
1/184 • Up to 6 months
Blood and lymphatic system disorders
Neutropenia
1.6%
3/184 • Up to 6 months
Blood and lymphatic system disorders
Pancytopenia
0.54%
1/184 • Up to 6 months
Blood and lymphatic system disorders
Thrombocytopenia
1.1%
2/184 • Up to 6 months
Ear and labyrinth disorders
Tinnitus
0.54%
1/184 • Up to 6 months
Gastrointestinal disorders
Abdominal pain
1.1%
2/184 • Up to 6 months
Gastrointestinal disorders
Nausea
1.6%
3/184 • Up to 6 months
Gastrointestinal disorders
Oral pain
0.54%
1/184 • Up to 6 months
Gastrointestinal disorders
Vomiting
0.54%
1/184 • Up to 6 months
General disorders
Chest pain
0.54%
1/184 • Up to 6 months
General disorders
Malaise
0.54%
1/184 • Up to 6 months
General disorders
Pyrexia
0.54%
1/184 • Up to 6 months
Infections and infestations
Bronchitis
0.54%
1/184 • Up to 6 months
Infections and infestations
Gingival infection
0.54%
1/184 • Up to 6 months
Infections and infestations
Gingivitis
0.54%
1/184 • Up to 6 months
Infections and infestations
Herpes zoster
0.54%
1/184 • Up to 6 months
Infections and infestations
Nasopharyngitis
1.1%
2/184 • Up to 6 months
Infections and infestations
Sinusitis
0.54%
1/184 • Up to 6 months
Infections and infestations
Tracheobronchitis
0.54%
1/184 • Up to 6 months
Infections and infestations
Upper respiratory tract infection
1.6%
3/184 • Up to 6 months
Infections and infestations
Urinary tract infection
0.54%
1/184 • Up to 6 months
Infections and infestations
Viral infection
0.54%
1/184 • Up to 6 months
Injury, poisoning and procedural complications
Infusion related reaction
0.54%
1/184 • Up to 6 months
Investigations
Alanine aminotransferase increased
1.6%
3/184 • Up to 6 months
Investigations
Arteriogram coronary
0.54%
1/184 • Up to 6 months
Investigations
Blood lactate dehydrogenase increased
0.54%
1/184 • Up to 6 months
Investigations
Blood thyroid stimulating hormone increased
0.54%
1/184 • Up to 6 months
Investigations
Blood triglycerides increased
0.54%
1/184 • Up to 6 months
Investigations
Full blood count decreased
0.54%
1/184 • Up to 6 months
Investigations
Hepatic enzyme increased
3.3%
6/184 • Up to 6 months
Investigations
Liver function test abnormal
1.1%
2/184 • Up to 6 months
Investigations
Neutrophil count decreased
0.54%
1/184 • Up to 6 months
Investigations
Platelet count decreased
0.54%
1/184 • Up to 6 months
Investigations
Transaminases increased
1.1%
2/184 • Up to 6 months
Metabolism and nutrition disorders
Hyperlipidaemia
1.6%
3/184 • Up to 6 months
Metabolism and nutrition disorders
Hypertriglyceridaemia
0.54%
1/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Back pain
0.54%
1/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Bursitis
1.1%
2/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Intervertebral disc disorder
0.54%
1/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Joint swelling
0.54%
1/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Myalgia
1.1%
2/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Pain in extremity
0.54%
1/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Rheumatoid arthritis
0.54%
1/184 • Up to 6 months
Musculoskeletal and connective tissue disorders
Sjogren's syndrome
0.54%
1/184 • Up to 6 months
Nervous system disorders
Dizziness
1.1%
2/184 • Up to 6 months
Nervous system disorders
Headache
1.1%
2/184 • Up to 6 months
Nervous system disorders
Hypoaesthesia
0.54%
1/184 • Up to 6 months
Nervous system disorders
Paraesthesia
0.54%
1/184 • Up to 6 months
Nervous system disorders
Syncope
0.54%
1/184 • Up to 6 months
Psychiatric disorders
Confusional state
0.54%
1/184 • Up to 6 months
Reproductive system and breast disorders
Breast pain
0.54%
1/184 • Up to 6 months
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
0.54%
1/184 • Up to 6 months
Respiratory, thoracic and mediastinal disorders
Dyspnoea
0.54%
1/184 • Up to 6 months
Skin and subcutaneous tissue disorders
Dermatitis allergic
1.1%
2/184 • Up to 6 months
Skin and subcutaneous tissue disorders
Hirsutism
0.54%
1/184 • Up to 6 months
Skin and subcutaneous tissue disorders
Pigmentation disorder
0.54%
1/184 • Up to 6 months
Skin and subcutaneous tissue disorders
Pruritus
1.1%
2/184 • Up to 6 months
Skin and subcutaneous tissue disorders
Psoriasis
0.54%
1/184 • Up to 6 months
Skin and subcutaneous tissue disorders
Rash
1.6%
3/184 • Up to 6 months
Skin and subcutaneous tissue disorders
Urticaria
0.54%
1/184 • Up to 6 months
Vascular disorders
Hypertension
1.1%
2/184 • Up to 6 months
Vascular disorders
Hypotension
0.54%
1/184 • Up to 6 months

Additional Information

Medical Communications

Hoffmann-LaRoche

Phone: 800-821-8590

Results disclosure agreements

  • Principal investigator is a sponsor employee The Study being conducted under this Agreement is part of the Overall Study. Investigator is free to publish in reputable journals or to present at professional conferences the results of the Study, but only after the first publication or presentation that involves the Overall Study. The Sponsor may request that Confidential Information be deleted and/or the publication be postponed in order to protect the Sponsor's intellectual property rights.
  • Publication restrictions are in place

Restriction type: OTHER