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Tocilizumab Increases Body Weight and Serum Adipokine Levels in Patients with Rheumatoid Arthritis Independently of Their Treatment Response: a Retrospective Cohort Study

Journal of Korean Medical Science 2020년 35권 22호 p.155 ~ 155
최인아 ( Choi In-Ah ) - Chungbuk National University Hospital Department of Internal Medicine

 ( Sagawa Akira ) - Sagawa Akira Rheumatology Clinic
이은영 ( Lee Eun-Young ) - Seoul National University Hospital Department of Internal Medicine
이은봉 ( Lee Eun-Bong ) - Seoul National University Hospital Department of Internal Medicine
송영욱 ( Song Yeong-Wook ) - Seoul National University Hospital Department of Internal Medicine

Abstract


Background: Causes of weight change after tocilizumab treatment are unclear. We aimed to investigate the effects of tocilizumab treatment on body weight and serum adipokine levels in patients with rheumatoid arthritis (RA).

Methods: In this retrospective cohort study, we evaluated weight changes in patients with RA who received methotrexate (Cohort I) or tocilizumab with methotrexate (Cohorts II and III) for 24 weeks. Adipokine concentrations at baseline and 24 weeks were analyzed in Cohorts I and III. Cohorts I and II received tocilizumab therapy for an additional 48 weeks, during which weight changes were monitored (24?72 weeks).

Results: No significant weight change occurred after 24 weeks of methotrexate treatment (mean difference, ?0.2 kg; P = 0.630), but was observed after 24 weeks of tocilizumab treatment (mean difference, +0.9 kg; P = 0.010). Weight changed regardless of the treatment response in both treatment groups. The leptin?adiponectin ratio (P = 0.015) and levels of adiponectin (P < 0.001), leptin (P < 0.001), and resistin (P = 0.003) increased significantly after 24 weeks of tocilizumab, but not methotrexate treatment. After 24, 48 and 72 weeks of tocilizumab treatment in Cohort II, mean (95% confidence interval [CI]) weight changes from baseline were +0.7 (0.0?1.4), +1.2 (0.4?2.0) and +1.1 (0.2?2.0) kg, respectively, and mean (95% CI) percent weight changes from baseline were +1.3% (0.1%?2.6%), +2.2% (0.7%?3.6%), and +2.0% (0.4%?3.7%) at 24, 48, and 72 weeks, respectively.

Conclusion: Weight and the leptin?adiponectin ratio increased after tocilizumab treatment. Given that cardiovascular (CV) risk factors may deteriorate in patients with RA who receive tocilizumab, further studies are required to determine the effects of weight gain on CV outcomes in these patients.

키워드

Adipokine; Interleukin-6 Receptor Inhibition; Rheumatoid Arthritis; Weight Gain
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