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Characterisation of depressive symptoms in rheumatoid arthritis patients treated with tocilizumab during routine daily care

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11


  1. CIRI/Rheumatology University Hospital and Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Branch for Translational Medicine and Pharmacology TMP and Fraunhofer Cluster of Excellence for Immune-Mediated Diseases CIMD, Goethe University, Frankfurt, Germany.
  2. Charité-Universitätsmedizin Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany.
  3. Rheumatologie/Klinische Immunologie, Kreiskliniken Altötting-Burghausen, Burghausen, Germany.
  4. Schwerpunktpraxis für Rheumatologie und Gastroenterologie, Munich, Germany.
  5. Internistisch-Rheumatologische Schwerpunktpraxis,Haldensleben, Germany.
  6. Internistisch-Rheumatologische Arztpraxis, Halle, Germany.
  7. Rheumazentrum Ratingen, Ratingen, Germany.
  8. Roche Pharma AG, Grenzach-Wyhlen, Germany.
  9. Roche Pharma AG, Grenzach-Wyhlen, Germany.
  10. Chugai Pharma Germany GmbH, Rheumatology, Frankfurt am Main, Germany.
  11. Rheumatologische Gemeinschaftspraxis, Bad Neuenahr, Germany.

2022 Vol.40, N°3
PI 0551, PF 0559
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PMID: 34001304 [PubMed]

Received: 16/10/2020
Accepted : 10/03/2021
In Press: 14/05/2021
Published: 22/03/2022


To assess whether tocilizumab treatment is associated with changes in depression symptoms in patients with rheumatoid arthritis (RA) during routine daily care.
We retrospectively analysed data from a German non-interventional study (ARATA) of adult, tocilizumab-naïve RA patients who initiated subcutaneous tocilizumab and were followed for 52 weeks. The Beck Depression Inventory II (BDI-II) was used to assess symptoms of depression and create baseline subgroups of no (BDI-II<14), mild (14–19), moderate (20–28), and severe (≥29) depression. Other key outcomes included Disease Activity Score-28 joints (DAS28), patient-reported outcomes (PROs), and adverse events. Mixed model repeated measures (MMRM) assessed the impact of DAS28 on BDI-II over time, and Pearson correlation analyses evaluated associations between changes from baseline.
Of 474/1155 ARATA patients who completed the BDI-II at baseline, 47.7% had evidence of depression: 18.4% mild, 17.7% moderate, and 11.6% severe. 229 patients (48.3%) completed the BDI-II at both baseline and week 52. Two-thirds of patients with moderate or severe depression at baseline improved to a milder or no depression subgroup at week 52 (44/65 [67.7%]). Improvements in disease activity and PROs were observed in all subgroups, but patients with depression had lower response and higher adverse events rates. We observed an association between DAS28 and BDI-II over time in MMRM analyses, but the Pearson correlation for change from baseline was weak (r=0.10).
Depression is common in patients receiving routine care for RA. Improvements in depressive symptoms in RA during tocilizumab therapy appear to be distinct from changes in disease activity.


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