Abstract Perspective: Comparison of efficacy between anti-IL-6 receptor antibody and other biological disease-modifying antirheumatic drugs in the patients with rheumatoid arthritis who have knee joint involvement: the ANSWER cohort, retrospective study

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It has been reported that patients with rheumatoid arthritis (RA), accompanied by large joint involvement were difficult to achieve remission. However, there have been no randomized controlled trials or cohort-based study which compare the efficacy of different biologic disease-modifying antirheumatic drugs (bDMARDs) in the RA patients with large joint involvement. This calls for the need of developing a better treatment strategy for RA with large joint involvement. In the present study, we investigated the efficacy of anti-IL-6 receptor antibody (aIL-6) and other bDMARDs, such as TNF-inhibitor and CTLA4-Ig in the treatment of RA in patients with knee joint involvement. Interestingly, we found that treatment with aIL-6 significantly increased ΔCDAI in patients with knee joint involvement, compared to other bDMARDs at 12 weeks by multivariate analysis. However, there was no significant difference in ΔCDAI improvement between aIL-6 and other bDMARDs in patients without swollen knee joints. ΔCDAI levels were equally increased in patients with shoulder and elbow joint involvement. Therefore, this study revealed that aIL-6 was more effective in the patients with RA who have knee joint involvement, compared to other bDMARDs.

– Dr. Maeda, study author