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TOSCARA Study: A Study of Subcutaneous Tocilizumab (RoActemra/Actemra) in Participants With Active Rheumatoid Arthritis Naïve to RoActemra/Actemra Treatment

TOSCARA: An Open-label, Single Arm Study to Evaluate the Efficacy, Safety and Tolerability of Tocilizumab (TCZ) Subcutaneous in TCZ-naïve Patients With Active Rheumatoid Arthritis

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02031471
Enrollment
57
Registered
2014-01-09
Start date
2014-01-31
Completion date
2015-09-30
Last updated
2017-08-01

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Rheumatoid Arthritis

Brief summary

This open-label, single-arm study will evaluate the efficacy, safety and tolerability of subcutaneously administered tocilizumab in monotherapy and/or in combination with methotrexate and other non-biologic disease modifying anti-rheumatic drug (DMARDs) in participants with active rheumatoid arthritis (RA) who are naïve to tocilizumab. Participants will receive tocilizumab 162 milligram (mg) subcutaneously weekly for 24 weeks. Participants who complete the core study achieving at least a moderate European League Against Rheumatism (EULAR) response at Week 24 may enter the extension phase and receive for a further 28 weeks at the most.

Interventions

DRUGtocilizumab

Fixed dose of 162 mg subcutaneously weekly

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Adult participants, \>/= 18 years of age * Active moderate to severe rheumatoid arthritis according to the revised (1987) American College of Rheumatology (ACR) criteria or EULAR/ACR (2010) criteria * Inadequate response or intolerant to previous therapy with two or more non-biologic disease-modifying anti-rheumatic drugs (DMARDs), one of which is methotrexate, administered in an optimal way during at least 3 months; eligible participants may also be inadequate responders to a maximum of one biologic DMARD * Oral corticosteroids (\</= 10 milligram per day (mg/day) prednisolone or equivalent) and non-steroidal anti-inflammatory drugs (NSAIDs; up to the recommended dose) are permitted if on stable dose regimen for \>/= 4 weeks prior to baseline * Permitted DMARDs are allowed if at stable dose for at least 4 weeks prior to baseline * Receiving treatment on an outpatient basis, not including tocilizumab * Females of childbearing potential and males with female partners of childbearing potential must agree to use reliable means of contraception as defined by protocol

Exclusion criteria

* Major surgery (including joint surgery) within 8 weeks prior to screening or planned major surgery within 6 months following baseline or during long term extension (LTE) period * Rheumatic autoimmune disease other than rheumatoid arthritis * Functional Class IV as defined by the ACR Classification of Functional Status in Rheumatoid Arthritis * Diagnosis of juvenile idiopathic arthritis or juvenile RA and/or RA before the age of 16 * Prior history of or current inflammatory joint disease other than RA * Exposure to tocilizumab (intravenous or subcutaneous) at any time prior to baseline * Treatment with any investigational agent within 4 weeks (or 5 half-lives of the investigational drug, whichever is longer) of screening * Intraarticular or parenteral corticosteroids within 4 weeks prior to baseline * History of severe allergic or anaphylactic reactions to human, humanized or murine monoclonal antibodies * Evidence of serious concomitant disease or disorder * Known active current or history of recurrent infection * Any major episode of infection requiring hospitalization or treatment with IV antibiotics within 4 weeks of screening or oral antibiotics within 2 weeks of screening * Active Tuberculosis (TB) requiring treatment within the previous 3 years * Positive for hepatitis B or hepatitis C * Primary or secondary immunodeficiency (history of or currently active) * Pregnant or lactating women * Neuropathies or other conditions that might interfere with pain evaluation * Inadequate hematologic, renal or liver function

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Disease Activity Score 28 - Erythrocyte Sedimentation Rate (DAS28-ESR) Score in the Full Analysis Set (FAS)From baseline to Week 24The DAS28 score is a measure of the participant's disease activity calculated using the tender joint count of 28 joints (TJC28), swollen joint count of 28 joints (SJC28), patient's global assessment of disease activity visual analog scale (PGA VAS) with 0=no disease activity to 100=maximum disease activity displayed on the 100-millimeter (mm) horizontal VAS and acute phase reactant (erythrocyte sedimentation rate \[ESR\] or C-reactive protein \[CRP\]) for a total possible score of 0 to 10. For this study ESR was used to calculate the DAS28 score. The index is calculated using the following formula: DAS28 = (0.56\*√\[TJC28\]) + (0.28\*√\[SJC28\]) + (0.70\*ln\[ESR\]) + (0.014\*VAS). Higher scores represent higher disease activity. A negative change from baseline indicates an improvement.
Change From Baseline in Disease Activity Score 28 - Erythrocyte Sedimentation Rate (DAS28-ESR) Score in the Per Protocol Set (PPS)From baseline to Week 24The DAS28 score is a measure of the participant's disease activity calculated using the TJC28, SJC28, PGA VAS with 0=no disease activity to 100=maximum disease activity displayed on the 100-mm horizontal VAS and acute phase reactant (ESR or CRP) for a total possible score of 0 to 10. For this study ESR was used to calculate the DAS28 score. The index is calculated using the following formula: DAS28 = (0.56\*√\[TJC28\]) + (0.28\*√\[SJC28\]) + (0.70\*ln\[ESR\]) + (0.014\*VAS). Higher scores represent higher disease activity. A negative change from baseline indicates an improvement.

Secondary

MeasureTime frameDescription
Change From Baseline in Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)From Baseline to Week 2, Week 24 and Week 52SDAI is a similar index to DAS28 but has the advantage of not needing a complicated mathematical formula for its determination, but a simple arithmetical addition of TJC28 and SJC28, PGA VAS and Physician Global Assessment of disease activity VAS, and CRP concentration in mg/L. CDAI does not incorporate an acute response, therefore it can be used to evaluate disease activity in the absence of laboratory testing of CRP and ESR. VAS range for all assessments was 0=no disease activity to 100=maximum disease activity displayed on the 100-mm horizontal VAS. SDAI scores ranged from 0 to 86, CDAI from 0 to 76 with higher scores indicating increased disease activity. A negative change from baseline indicates an improvement.
Change in Total Tender/Swollen Joint Counts (TJC/SJC)From Baseline to Week 2, Week 24 and Week 52An assessment of 66 joints for swelling and 68 joints for tenderness was made. Joints were assessed and classified as swollen/not swollen and tender/not tender by pressure and joint manipulation on physical examination. Joint prosthesis, arthrodesis or fused joints were not taken into consideration for swelling or tenderness. A negative change from baseline indicates an improvement.
Percentage of Participants With Corticosteroid Dose Reduction/DiscontinuationUp to Week 52
Percentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityBaseline to Week 2, Week 24 and Week 52CDAI is calculated by simple arithmetical addition of TJC28 and SJC28, PGA VAS and Physician Global Assessment of disease activity VAS. VAS range was 0=no disease activity to 100=maximum disease activity displayed on the 100-mm horizontal VAS. Total CDAI score ranges from 0 to 76 with higher scores indicating increased disease activity. Clinical remission = score ≤ 2.8; Low disease activity = score \> 2.8 and ≤ 10.0; Moderate disease activity = score \> 10.0 and ≤ 22.0; High disease activity = score \> 22.0.
Percentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityFrom Baseline to Week 2, Week 24 and Week 52SDAI is calculated by simple arithmetical addition of TJC28 and SJC28, PGA VAS and Physician Global Assessment of disease activity VAS, and CRP concentration in mg/L. VAS range was 0=no disease activity to 100=maximum disease activity displayed on the 100-mm horizontal VAS. Total SDAI score ranges from 0 to 86 with higher scores indicating increased disease activity. Clinical remission = score ≤ 3.3; Low disease activity = score \> 3.3 and ≤ 11.0; Moderate disease activity = score \> 11.0 and ≤ 26.0; high disease activity = score \> 26.0.
Percentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityFrom Baseline to Week 2, Week 24 and Week 52The DAS28 score is a measure of the participant's disease activity calculated using TJC28, SJC28, PGA VAS with 0=no disease activity to 100=maximum disease activity displayed on the 100-millimeter (mm) horizontal VAS and acute phase reactant (erythrocyte sedimentation rate \[ESR\] or C-reactive protein \[CRP\]) for a total possible score of 0 to 10. For this study ESR was used to calculate the DAS28 score. The index is calculated using the following formula: DAS28 = (0.56\*√\[TJC28\]) + (0.28\*√\[SJC28\]) + (0.70\*ln\[ESR\]) + (0.014\*VAS). Higher scores represent higher disease activity. Clinical remission = score \<2.6; Low disease activity = score ≥2.6 and ≤3.2; Moderate disease activity = score \> 3.2 and ≤5.1; High disease activity = score \>5.1.
Percentage of Participants Achieving a Clinically Significant Improvement in DAS28From Baseline to Week 2, Week 24 and Week 52The DAS28 score is a measure of the participant's disease activity calculated using TJC28, SJC28, PGA VAS with 0=no disease activity to 100=maximum disease activity displayed on the 100-millimeter (mm) horizontal VAS and acute phase reactant (erythrocyte sedimentation rate \[ESR\] or C-reactive protein \[CRP\]) for a total possible score of 0 to 10. For this study ESR was used to calculate the DAS28 score. The index is calculated using the following formula: DAS28 = (0.56\*√\[TJC28\]) + (0.28\*√\[SJC28\]) + (0.70\*ln\[ESR\]) + (0.014\*VAS). Higher scores represent higher disease activity. DAS28 Clinically Significant Improvement was defined as a DAS28 score reduction of at least 1.2 units from Baseline.
Change From Baseline in Physician's Global Assessment of Disease Activity VASFrom Baseline to Week 2, Week 24 and Week 52Physician's Global Assessment of disease activity VAS represents the physician's assessment of the participant's current disease activity on a 100 mm horizontal VAS. The extreme left end of the line represents 0= no disease activity (symptom-free and no arthritis symptoms) and the extreme right end 100= maximum disease activity. This was completed by the Treating Physician (or designee). A negative change from baseline indicates an improvement.
Change From Baseline in Patient's Global Assessment of Disease Activity VASFrom Baseline to Week 2, Week 24 and Week 52PGA VAS represents the participant's overall assessment of their current disease activity on a 100 mm horizontal VAS. The extreme left end of the line represents 0= no disease activity (symptom-free and no arthritis symptoms) and the extreme right end 100=maximum disease activity (maximum arthritis disease activity). A negative change from baseline indicates an improvement.
Change From Baseline in Patient's Assessment of Pain VASFrom Baseline to Week 2 and Week 24Patient's Assessment of Pain VAS represents the participant's assessment of his/her current level of pain on a 100 mm horizontal VAS. The extreme left end of the line represents 0=no pain and the extreme right end 100=unbearable pain. A negative change from baseline indicates an improvement.
Acute Phase Reactants: Change From Baseline in CRPFrom Baseline to Week 2, Week 24 and Week 52A negative change from baseline in CRP level indicates an improvement.
Percentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresFrom Baseline to Week 2, Week 24, and Week 52The ACR core set of outcome measures and their definition of improvement includes a \>= 20% improvement (ACR20) compared to Baseline in both SJC and TJC as well as in three out of five additional parameters: Physician's Global Assessment of disease activity VAS, PGA VAS, patient's assessment of pain VAS, Health Assessment Questionnaire-Disability Index (HAQ-DI), and acute phase reactant (CRP or ESR). VAS range for all assessments was 0=no disease activity to 100=maximum disease activity displayed on the 100-mm horizontal VAS. Achievement of an ACR50 requires a \>= 50% improvement in the same parameters and an ACR70 requires a \>= 70% improvement.
Change From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI)From Baseline to Week 2, Week 24 and Week 52The Stanford HAQ-DI is a patient-oriented outcome assessment questionnaire specific for rheumatoid arthritis. It consists of 20 questions referring to eight component sets: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and other common activities. Each category contains multiple questions, which were answered using a 4-point scale from 0 to 3. The overall index score was an average of the individual item responses and may range from 0 to 3, where higher scores indicate more difficulty in daily living activities. A negative change from baseline indicates an improvement.
Change From Baseline in Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F)From Baseline to Week 2, Week 24 and Week 52The symptom-specific measure FACIT-F was developed to assess chronic illness therapy with special emphasis on fatigue in the past 7 days. In this study, only the FACIT-F short questionnaire, which is a shorter version of the initial FACIT-F questionnaire, was used. Each of the questions is categorically answered using the scales 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The figures are reversed during score calculations, so that higher score values indicate more favorable conditions. The 13 items included in the FACIT-F short can be used to calculate the brief score for FACIT-F scale (score range: 0-52). A positive change from baseline indicates an improvement.
Change From Baseline in Pittsburgh Sleep Quality Index (PSQI)From Baseline to Week 4, Week 24 and Week 52The PSQI is a self-rated questionnaire which assesses sleep quality and disturbances over 1-month time interval. Nineteen individual items generate seven component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The participant self-rates each of these seven areas of sleep. Scoring of answers is based on a 0 to 3 scale, whereby 3 reflects the negative extreme on the Likert Scale. Global scores range from 0 to 21 and a global sum of 5 or greater indicates a poor sleeper. Although there are several questions that request the evaluation of the participant's bed mate or roommate, these are not scored. A negative change from baseline indicates an improvement.
Change From Baseline in Patient Quality of Sleep VASFrom Baseline to Week 2, Week 24 and Week 52The Patient Quality of Sleep VAS assessment represents the participant's assessment of his/her current quality of sleep on a 100 mm horizontal VAS. The extreme left end of the line represents 0=no difficulty to sleep and the extreme right end 100=extreme sleeping difficulties. A negative change from baseline indicates an improvement.
Change From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)From Baseline to Week 4, Week 24 and Week 52The AIMS-SF is a reduced version of the validated AIMS2 questionnaire. The Short Form has been developed using a comprehensive expert-based approach and supported by psychometric testing. The AIMS-SF is a self-administered questionnaire to measure changes in global health, pain, mobility and social function in adult patients with arthritis and reports scores for physical, symptoms, affect, social and work assessments. Scores range from 0 to 10, higher scores indicating higher impact of arthritis on the assessments. A negative change from baseline indicates an improvement.
Change From Baseline in Patient Fatigue VASFrom Baseline to Week 2, Week 24 and Week 52The Patient Fatigue VAS assessment represents the participant's assessment of his/her current level of fatigue on a 100 mm horizontal VAS. The extreme left end of the line represents 0=no fatigue and the extreme right end 100=extreme fatigue. A negative change from baseline indicates an improvement.
Change From Baseline in Patient Satisfaction VASFrom Baseline to Week 2, Week 24 and Week 52The Patient Satisfaction VAS assessment represents the participant's assessment of his/her current satisfaction with treatment on a 100 mm horizontal VAS. The extreme left end of the line represents 0=no satisfaction and the extreme right end 100=extremely satisfied. A positive change from baseline indicates an improvement.
Change From Baseline in Work Instability Scale for Rheumatoid Arthritis (RA-WIS)From Baseline to Week 24The 23-item RA-WIS is a simple, validated screening tool for work instability, i.e., the consequences of a mismatch between an individual's functional ability and their work tasks. This self-administered questionnaire covers a broad range of specific work-related issues and enables monitoring the risk of work disability in rheumatoid arthritis patients. The RA-WIS is scored by summing responses from all 23 scale items. The scale ranges from 0 to 23. Cut points have been established to differentiate levels of work instability: low \< 10, moderate 10-17 and high \> 17. A negative change from baseline indicates an improvement.
Treatment Satisfaction Questionnaire for Medication (TSQM ) ScoresWeek 24The abbreviated 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9) derived from the TSQM Version 1.4 but without the five items of the side effects domain, is a reliable and valid measure to assess participants' satisfaction with treatment. The TSQM-9 domain scores range from 0 to 100 with higher scores representing higher satisfaction on that domain. Domains included are effectiveness, convenience and global satisfaction.
Safety: Percentage of Participants With Adverse EventsUp to 52 weeksAn adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.
Safety: Percentage of Participants With Anti-tocilizumab AntibodiesBaseline, Week 24
Acute Phase Reactants: Change From Baseline in ESRFrom Baseline to Week 2, Week 24 and Week 52A negative change from baseline in ESR indicates an improvement.
Percentage of Participants With Responses According to European League Against Rheumatism (EULAR ) CriteriaFrom Baseline to Week 2, Week 24EULAR response was calculated as the difference between DAS28-ESR scores at baseline and Week 24, and reported as the percentage of participants with good, moderate, or no response. Good responders = decrease from baseline \>1.2 with a DAS28 score of \<=3.2; moderate responders = decrease from baseline \>1.2 with a DAS28 score of \>3.2, or decrease from baseline \>0.6 to \<=1.2 with a DAS28 score of \<=5.1; non-responders = decrease from baseline \<=0.6 or decrease from baseline \>0.6 and \<=1.2 with a DAS28 score of \>5.1.

Countries

Belgium, Luxembourg

Participant flow

Pre-assignment details

A total of 62 participants were screened, 57 participants were enrolled. Participants who completed the 24 Week Treatment Period achieving at least a moderate European League Against Rheumatism (EULAR) response at Week 24 were allowed to enter the Long Term Extension (LTE) Period.

Participants by arm

ArmCount
Tocilizumab
Adults with rheumatoid arthritis received a fixed dose of tocilizumab during the 24-week open-label core study and those entering the LTE period further received a fixed dose up to a maximum of 28 weeks or until tocilizumab was commercially available and/or reimbursed whichever came first. A fixed dose of 162 mg tocilizumab was administered subcutaneously once weekly.
57
Total57

Withdrawals & dropouts

PeriodReasonFG000
24 Week Treatment PeriodAdverse Event6
24 Week Treatment PeriodHypersensitivity Reaction1
24 Week Treatment PeriodInsufficient Therapeutic Response1
24 Week Treatment PeriodParticipant Decision to Withdraw2
24 Week Treatment PeriodProtocol Violation1
Long Term Extension (LTE) PeriodAdverse Event1
Long Term Extension (LTE) PeriodInsufficient Therapeutic Response1

Baseline characteristics

CharacteristicTocilizumab
Age, Continuous54.49 years
STANDARD_DEVIATION 11.08
Sex: Female, Male
Female
44 Participants
Sex: Female, Male
Male
13 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
36 / 57
serious
Total, serious adverse events
5 / 57

Outcome results

Primary

Change From Baseline in Disease Activity Score 28 - Erythrocyte Sedimentation Rate (DAS28-ESR) Score in the Full Analysis Set (FAS)

The DAS28 score is a measure of the participant's disease activity calculated using the tender joint count of 28 joints (TJC28), swollen joint count of 28 joints (SJC28), patient's global assessment of disease activity visual analog scale (PGA VAS) with 0=no disease activity to 100=maximum disease activity displayed on the 100-millimeter (mm) horizontal VAS and acute phase reactant (erythrocyte sedimentation rate \[ESR\] or C-reactive protein \[CRP\]) for a total possible score of 0 to 10. For this study ESR was used to calculate the DAS28 score. The index is calculated using the following formula: DAS28 = (0.56\*√\[TJC28\]) + (0.28\*√\[SJC28\]) + (0.70\*ln\[ESR\]) + (0.014\*VAS). Higher scores represent higher disease activity. A negative change from baseline indicates an improvement.

Time frame: From baseline to Week 24

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Disease Activity Score 28 - Erythrocyte Sedimentation Rate (DAS28-ESR) Score in the Full Analysis Set (FAS)Baseline (n=56)5.55 Units on a scaleStandard Deviation 1.17
TocilizumabChange From Baseline in Disease Activity Score 28 - Erythrocyte Sedimentation Rate (DAS28-ESR) Score in the Full Analysis Set (FAS)Change at Week 24 (n=42)-3.24 Units on a scaleStandard Deviation 1.47
Primary

Change From Baseline in Disease Activity Score 28 - Erythrocyte Sedimentation Rate (DAS28-ESR) Score in the Per Protocol Set (PPS)

The DAS28 score is a measure of the participant's disease activity calculated using the TJC28, SJC28, PGA VAS with 0=no disease activity to 100=maximum disease activity displayed on the 100-mm horizontal VAS and acute phase reactant (ESR or CRP) for a total possible score of 0 to 10. For this study ESR was used to calculate the DAS28 score. The index is calculated using the following formula: DAS28 = (0.56\*√\[TJC28\]) + (0.28\*√\[SJC28\]) + (0.70\*ln\[ESR\]) + (0.014\*VAS). Higher scores represent higher disease activity. A negative change from baseline indicates an improvement.

Time frame: From baseline to Week 24

Population: The PPS consisted of all participants of the FAS having a value at baseline and at Week 24 for the endpoint DAS28-ESR, excluding sponsor defined deviation(s) which could have affected the evaluation of the primary endpoint (DAS28-ESR). Here, n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Disease Activity Score 28 - Erythrocyte Sedimentation Rate (DAS28-ESR) Score in the Per Protocol Set (PPS)Baseline (n= 27)5.73 Units on a scaleStandard Deviation 1.33
TocilizumabChange From Baseline in Disease Activity Score 28 - Erythrocyte Sedimentation Rate (DAS28-ESR) Score in the Per Protocol Set (PPS)Change at Week 24 (n= 20)-3.21 Units on a scaleStandard Deviation 1.42
Secondary

Acute Phase Reactants: Change From Baseline in CRP

A negative change from baseline in CRP level indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabAcute Phase Reactants: Change From Baseline in CRPBaseline (n=55)13.79 milligrams per liter (mg/L)Standard Deviation 20.78
TocilizumabAcute Phase Reactants: Change From Baseline in CRPChange at Week 2 (n=54)-13.19 milligrams per liter (mg/L)Standard Deviation 20.64
TocilizumabAcute Phase Reactants: Change From Baseline in CRPChange at Week 24 (n=42)-10.12 milligrams per liter (mg/L)Standard Deviation 14.5
TocilizumabAcute Phase Reactants: Change From Baseline in CRPChange at Week 52 (n=8)-25.07 milligrams per liter (mg/L)Standard Deviation 23.03
Secondary

Acute Phase Reactants: Change From Baseline in ESR

A negative change from baseline in ESR indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabAcute Phase Reactants: Change From Baseline in ESRBaseline (n=56)33.75 millimeters per hour (mm/hr)Standard Deviation 28.9
TocilizumabAcute Phase Reactants: Change From Baseline in ESRChange at Week 2 (n=55)-19.95 millimeters per hour (mm/hr)Standard Deviation 18.22
TocilizumabAcute Phase Reactants: Change From Baseline in ESRChange at Week 24 (n=44)-22.80 millimeters per hour (mm/hr)Standard Deviation 24.88
TocilizumabAcute Phase Reactants: Change From Baseline in ESRChange at Week 52 (n=9)-27.78 millimeters per hour (mm/hr)Standard Deviation 23.82
Secondary

Change From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)

The AIMS-SF is a reduced version of the validated AIMS2 questionnaire. The Short Form has been developed using a comprehensive expert-based approach and supported by psychometric testing. The AIMS-SF is a self-administered questionnaire to measure changes in global health, pain, mobility and social function in adult patients with arthritis and reports scores for physical, symptoms, affect, social and work assessments. Scores range from 0 to 10, higher scores indicating higher impact of arthritis on the assessments. A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 4, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here, n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Baseline: Physical (n= 49)3.57 Units on a scaleStandard Deviation 1.92
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 4: Physical (n= 47)-0.57 Units on a scaleStandard Deviation 1.36
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 24: Physical (n=38)-1.41 Units on a scaleStandard Deviation 1.83
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 52: Physical (n=3)-3.62 Units on a scaleStandard Deviation 2.23
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Baseline: Symptom (50)6.33 Units on a scaleStandard Deviation 2.59
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 4: Symptom (n= 48)-1.15 Units on a scaleStandard Deviation 2.46
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 24: Symptom (n=40)-2.69 Units on a scaleStandard Deviation 2.8
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 52: Symptom (n=3)-3.89 Units on a scaleStandard Deviation 5.91
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Baseline: Affect (n=50)5.07 Units on a scaleStandard Deviation 2.22
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 4: Affect (n= 48)-0.66 Units on a scaleStandard Deviation 1.56
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 24: Affect (n=40)-1.74 Units on a scaleStandard Deviation 2.22
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 52: Affect (n=3)-4.50 Units on a scaleStandard Deviation 2.22
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Baseline: Social (n=50)5.36 Units on a scaleStandard Deviation 1.73
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 4: Social (n= 48)0.18 Units on a scaleStandard Deviation 1.41
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 24: Social (n=40)-0.56 Units on a scaleStandard Deviation 1.61
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 52: Social (n=3)-1.46 Units on a scaleStandard Deviation 2.37
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Baseline: Work (n=26)3.17 Units on a scaleStandard Deviation 2.46
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 4: Work (n= 23)-0.92 Units on a scaleStandard Deviation 2.53
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 24: Work (n=21)-0.65 Units on a scaleStandard Deviation 2.87
TocilizumabChange From Baseline in Arthritis Impact Measurement Scale-Short Form (AIMS-SF)Change at Week 52: Work (n=1)3.75 Units on a scale
Secondary

Change From Baseline in Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F)

The symptom-specific measure FACIT-F was developed to assess chronic illness therapy with special emphasis on fatigue in the past 7 days. In this study, only the FACIT-F short questionnaire, which is a shorter version of the initial FACIT-F questionnaire, was used. Each of the questions is categorically answered using the scales 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The figures are reversed during score calculations, so that higher score values indicate more favorable conditions. The 13 items included in the FACIT-F short can be used to calculate the brief score for FACIT-F scale (score range: 0-52). A positive change from baseline indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F)Baseline (n=57)26.09 Units on a scaleStandard Deviation 10.75
TocilizumabChange From Baseline in Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F)Change at Week 2 (n=57)2.32 Units on a scaleStandard Deviation 9.58
TocilizumabChange From Baseline in Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F)Change at Week 24 (n=45)10.53 Units on a scaleStandard Deviation 12.06
TocilizumabChange From Baseline in Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F)Change at Week 52 (n=9)20.89 Units on a scaleStandard Deviation 12.35
Secondary

Change From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI)

The Stanford HAQ-DI is a patient-oriented outcome assessment questionnaire specific for rheumatoid arthritis. It consists of 20 questions referring to eight component sets: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and other common activities. Each category contains multiple questions, which were answered using a 4-point scale from 0 to 3. The overall index score was an average of the individual item responses and may range from 0 to 3, where higher scores indicate more difficulty in daily living activities. A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI)Baseline (n=57)1.44 Units on a scaleStandard Deviation 0.68
TocilizumabChange From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI)Change at Week 2 (n=57)-0.08 Units on a scaleStandard Deviation 0.43
TocilizumabChange From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI)Change at Week 24 (n=46)-0.54 Units on a scaleStandard Deviation 0.68
TocilizumabChange From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI)Change at Week 52 (n=9)-1.33 Units on a scaleStandard Deviation 0.68
Secondary

Change From Baseline in Patient Fatigue VAS

The Patient Fatigue VAS assessment represents the participant's assessment of his/her current level of fatigue on a 100 mm horizontal VAS. The extreme left end of the line represents 0=no fatigue and the extreme right end 100=extreme fatigue. A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Patient Fatigue VASBaseline (n=57)60.19 Units on a scaleStandard Deviation 24.79
TocilizumabChange From Baseline in Patient Fatigue VASChange at Week 2 (n=57)-3.74 Units on a scaleStandard Deviation 20.68
TocilizumabChange From Baseline in Patient Fatigue VASChange at Week 24 (n=46)-21.48 Units on a scaleStandard Deviation 28.07
TocilizumabChange From Baseline in Patient Fatigue VASChange at Week 52 (n=9)-50.89 Units on a scaleStandard Deviation 26.11
Secondary

Change From Baseline in Patient Quality of Sleep VAS

The Patient Quality of Sleep VAS assessment represents the participant's assessment of his/her current quality of sleep on a 100 mm horizontal VAS. The extreme left end of the line represents 0=no difficulty to sleep and the extreme right end 100=extreme sleeping difficulties. A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Patient Quality of Sleep VASBaseline (n=57)54.95 Units on a scaleStandard Deviation 31.23
TocilizumabChange From Baseline in Patient Quality of Sleep VASChange at Week 2 (n=57)-8.40 Units on a scaleStandard Deviation 23.72
TocilizumabChange From Baseline in Patient Quality of Sleep VASChange at Week 24 (n=46)-21.93 Units on a scaleStandard Deviation 30.87
TocilizumabChange From Baseline in Patient Quality of Sleep VASChange at Week 52 (n=9)-34.22 Units on a scaleStandard Deviation 37.03
Secondary

Change From Baseline in Patient's Assessment of Pain VAS

Patient's Assessment of Pain VAS represents the participant's assessment of his/her current level of pain on a 100 mm horizontal VAS. The extreme left end of the line represents 0=no pain and the extreme right end 100=unbearable pain. A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 2 and Week 24

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Patient's Assessment of Pain VASBaseline (n=57)66.77 Units on a scaleStandard Deviation 21.43
TocilizumabChange From Baseline in Patient's Assessment of Pain VASChange at Week 2 (n=57)-11.32 Units on a scaleStandard Deviation 19.74
TocilizumabChange From Baseline in Patient's Assessment of Pain VASChange at Week 24 (n=46)-35.37 Units on a scaleStandard Deviation 27.03
TocilizumabChange From Baseline in Patient's Assessment of Pain VASChange at Week 52 (n=9)-49.33 Units on a scaleStandard Deviation 39.58
Secondary

Change From Baseline in Patient Satisfaction VAS

The Patient Satisfaction VAS assessment represents the participant's assessment of his/her current satisfaction with treatment on a 100 mm horizontal VAS. The extreme left end of the line represents 0=no satisfaction and the extreme right end 100=extremely satisfied. A positive change from baseline indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Patient Satisfaction VASBaseline (n=53)39.66 Units on a scaleStandard Deviation 28.63
TocilizumabChange From Baseline in Patient Satisfaction VASChange at Week 2 (n=53)9.49 Units on a scaleStandard Deviation 33.97
TocilizumabChange From Baseline in Patient Satisfaction VASChange at Week 24 (n=43)33.07 Units on a scaleStandard Deviation 35.5
TocilizumabChange From Baseline in Patient Satisfaction VASChange at Week 52 (n=8)49.38 Units on a scaleStandard Deviation 35.12
Secondary

Change From Baseline in Patient's Global Assessment of Disease Activity VAS

PGA VAS represents the participant's overall assessment of their current disease activity on a 100 mm horizontal VAS. The extreme left end of the line represents 0= no disease activity (symptom-free and no arthritis symptoms) and the extreme right end 100=maximum disease activity (maximum arthritis disease activity). A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Patient's Global Assessment of Disease Activity VASBaseline (n=57)67.28 Units on a scaleStandard Deviation 22.25
TocilizumabChange From Baseline in Patient's Global Assessment of Disease Activity VASChange at Week 2 (n=57)-11.82 Units on a scaleStandard Deviation 23.23
TocilizumabChange From Baseline in Patient's Global Assessment of Disease Activity VASChange at Week 24 (n=46)-36.02 Units on a scaleStandard Deviation 29.38
TocilizumabChange From Baseline in Patient's Global Assessment of Disease Activity VASChange at Week 52 (n=9)-44.78 Units on a scaleStandard Deviation 35.87
Secondary

Change From Baseline in Physician's Global Assessment of Disease Activity VAS

Physician's Global Assessment of disease activity VAS represents the physician's assessment of the participant's current disease activity on a 100 mm horizontal VAS. The extreme left end of the line represents 0= no disease activity (symptom-free and no arthritis symptoms) and the extreme right end 100= maximum disease activity. This was completed by the Treating Physician (or designee). A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Physician's Global Assessment of Disease Activity VASBaseline (n=56)64.93 Units on a scaleStandard Deviation 17.73
TocilizumabChange From Baseline in Physician's Global Assessment of Disease Activity VASChange at Week 2 (n=56)-16.34 Units on a scaleStandard Deviation 16.88
TocilizumabChange From Baseline in Physician's Global Assessment of Disease Activity VASChange at Week 24 (n=45)-48.93 Units on a scaleStandard Deviation 25.06
TocilizumabChange From Baseline in Physician's Global Assessment of Disease Activity VASChange at Week 52 (n=9)-57.44 Units on a scaleStandard Deviation 23.26
Secondary

Change From Baseline in Pittsburgh Sleep Quality Index (PSQI)

The PSQI is a self-rated questionnaire which assesses sleep quality and disturbances over 1-month time interval. Nineteen individual items generate seven component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The participant self-rates each of these seven areas of sleep. Scoring of answers is based on a 0 to 3 scale, whereby 3 reflects the negative extreme on the Likert Scale. Global scores range from 0 to 21 and a global sum of 5 or greater indicates a poor sleeper. Although there are several questions that request the evaluation of the participant's bed mate or roommate, these are not scored. A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 4, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Pittsburgh Sleep Quality Index (PSQI)Baseline (n=57)8.81 Units on a scaleStandard Deviation 4.39
TocilizumabChange From Baseline in Pittsburgh Sleep Quality Index (PSQI)Change at Week 4 (n=54)-1.24 Units on a scaleStandard Deviation 3.53
TocilizumabChange From Baseline in Pittsburgh Sleep Quality Index (PSQI)Change at Week 24 (n=46)-2.63 Units on a scaleStandard Deviation 4.14
TocilizumabChange From Baseline in Pittsburgh Sleep Quality Index (PSQI)Change at Week 52 (n=9)-4.56 Units on a scaleStandard Deviation 5.88
Secondary

Change From Baseline in Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)

SDAI is a similar index to DAS28 but has the advantage of not needing a complicated mathematical formula for its determination, but a simple arithmetical addition of TJC28 and SJC28, PGA VAS and Physician Global Assessment of disease activity VAS, and CRP concentration in mg/L. CDAI does not incorporate an acute response, therefore it can be used to evaluate disease activity in the absence of laboratory testing of CRP and ESR. VAS range for all assessments was 0=no disease activity to 100=maximum disease activity displayed on the 100-mm horizontal VAS. SDAI scores ranged from 0 to 86, CDAI from 0 to 76 with higher scores indicating increased disease activity. A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)Baseline (n=53)33.26 Units on a scaleStandard Deviation 13.5
TocilizumabChange From Baseline in Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)Change at Week 2: SDAI (n=52)-9.00 Units on a scaleStandard Deviation 11.89
TocilizumabChange From Baseline in Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)Change at Week 24: SDAI (n=38)-25.33 Units on a scaleStandard Deviation 13.63
TocilizumabChange From Baseline in Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)Change at Week 52: SDAI (n=7)-34.04 Units on a scaleStandard Deviation 16.01
TocilizumabChange From Baseline in Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)Baseline: CDAI (n= 55)31.86 Units on a scaleStandard Deviation 12.6
TocilizumabChange From Baseline in Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)Change at Week 2: CDAI (n=55)-7.61 Units on a scaleStandard Deviation 11.51
TocilizumabChange From Baseline in Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)Change at Week 24: CDAI (n=42)-23.55 Units on a scaleStandard Deviation 13.03
TocilizumabChange From Baseline in Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)Change at Week 52: CDAI (n=8)-29.99 Units on a scaleStandard Deviation 13.89
Secondary

Change From Baseline in Work Instability Scale for Rheumatoid Arthritis (RA-WIS)

The 23-item RA-WIS is a simple, validated screening tool for work instability, i.e., the consequences of a mismatch between an individual's functional ability and their work tasks. This self-administered questionnaire covers a broad range of specific work-related issues and enables monitoring the risk of work disability in rheumatoid arthritis patients. The RA-WIS is scored by summing responses from all 23 scale items. The scale ranges from 0 to 23. Cut points have been established to differentiate levels of work instability: low \< 10, moderate 10-17 and high \> 17. A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 24

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange From Baseline in Work Instability Scale for Rheumatoid Arthritis (RA-WIS)Baseline (n=26)13.15 Units on a scaleStandard Deviation 6.05
TocilizumabChange From Baseline in Work Instability Scale for Rheumatoid Arthritis (RA-WIS)Change at Week 24 (n=22)-3.55 Units on a scaleStandard Deviation 6.96
Secondary

Change in Total Tender/Swollen Joint Counts (TJC/SJC)

An assessment of 66 joints for swelling and 68 joints for tenderness was made. Joints were assessed and classified as swollen/not swollen and tender/not tender by pressure and joint manipulation on physical examination. Joint prosthesis, arthrodesis or fused joints were not taken into consideration for swelling or tenderness. A negative change from baseline indicates an improvement.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here, n is the number of participants with evaluable data for this outcome measure

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabChange in Total Tender/Swollen Joint Counts (TJC/SJC)Baseline: TJC (n=53)16.02 Joint CountsStandard Deviation 11.77
TocilizumabChange in Total Tender/Swollen Joint Counts (TJC/SJC)Change at Week 2: TJC (n=53)-3.58 Joint CountsStandard Deviation 8.91
TocilizumabChange in Total Tender/Swollen Joint Counts (TJC/SJC)Change at Week 24: TJC (n=41)-12.10 Joint CountsStandard Deviation 11.07
TocilizumabChange in Total Tender/Swollen Joint Counts (TJC/SJC)Change at Week 52: TJC (n=8)-17.25 Joint CountsStandard Deviation 13.02
TocilizumabChange in Total Tender/Swollen Joint Counts (TJC/SJC)Baseline: SJC (n=55)10.20 Joint CountsStandard Deviation 7.14
TocilizumabChange in Total Tender/Swollen Joint Counts (TJC/SJC)Change at Week 2: SJC (n=55)-3.93 Joint CountsStandard Deviation 7.33
TocilizumabChange in Total Tender/Swollen Joint Counts (TJC/SJC)Change at Week 24: SJC (n=42)-9.81 Joint CountsStandard Deviation 7.84
TocilizumabChange in Total Tender/Swollen Joint Counts (TJC/SJC)Change at Week 52: SJC (n=8)-11.75 Joint CountsStandard Deviation 7.76
Secondary

Percentage of Participants Achieving a Clinically Significant Improvement in DAS28

The DAS28 score is a measure of the participant's disease activity calculated using TJC28, SJC28, PGA VAS with 0=no disease activity to 100=maximum disease activity displayed on the 100-millimeter (mm) horizontal VAS and acute phase reactant (erythrocyte sedimentation rate \[ESR\] or C-reactive protein \[CRP\]) for a total possible score of 0 to 10. For this study ESR was used to calculate the DAS28 score. The index is calculated using the following formula: DAS28 = (0.56\*√\[TJC28\]) + (0.28\*√\[SJC28\]) + (0.70\*ln\[ESR\]) + (0.014\*VAS). Higher scores represent higher disease activity. DAS28 Clinically Significant Improvement was defined as a DAS28 score reduction of at least 1.2 units from Baseline.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here, n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (NUMBER)
TocilizumabPercentage of Participants Achieving a Clinically Significant Improvement in DAS28Week 2 (n=56)66.1 percentage of participants
TocilizumabPercentage of Participants Achieving a Clinically Significant Improvement in DAS28Week 24 (n=42)90.5 percentage of participants
TocilizumabPercentage of Participants Achieving a Clinically Significant Improvement in DAS28Week 52 (n=8)100 percentage of participants
Secondary

Percentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease Activity

CDAI is calculated by simple arithmetical addition of TJC28 and SJC28, PGA VAS and Physician Global Assessment of disease activity VAS. VAS range was 0=no disease activity to 100=maximum disease activity displayed on the 100-mm horizontal VAS. Total CDAI score ranges from 0 to 76 with higher scores indicating increased disease activity. Clinical remission = score ≤ 2.8; Low disease activity = score \> 2.8 and ≤ 10.0; Moderate disease activity = score \> 10.0 and ≤ 22.0; High disease activity = score \> 22.0.

Time frame: Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here, n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (NUMBER)
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityBaseline: Clinical remission (n=55)0 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 2: Clinical remission (n=56)1.8 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 24: Clinical remission (n=43)30.2 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 52: Clinical remission (n=8)37.5 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityBaseline: Low disease activity (n=55)0 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 2: Low disease activity (n=56)7.1 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 24: Low disease activity (n=43)34.9 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 52: Low disease activity (n=8)25.0 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 52: High disease activity (n=8)0 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityBaseline: Moderate disease activity (n=55)21.8 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 2: Moderate disease activity (n=56)48.2 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 24: Moderate disease activity (n=43)30.2 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 52: Moderate disease activity (n=8)37.5 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityBaseline: High disease activity (n=55)78.2 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 2: High disease activity (n=56)42.9 percentage of participants
TocilizumabPercentage of Participants Achieving CDAI Remission, CDAI Low Disease Activity, Moderate Disease Activity and High Disease ActivityWeek 24: High disease activity (n=43)4.7 percentage of participants
Secondary

Percentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease Activity

The DAS28 score is a measure of the participant's disease activity calculated using TJC28, SJC28, PGA VAS with 0=no disease activity to 100=maximum disease activity displayed on the 100-millimeter (mm) horizontal VAS and acute phase reactant (erythrocyte sedimentation rate \[ESR\] or C-reactive protein \[CRP\]) for a total possible score of 0 to 10. For this study ESR was used to calculate the DAS28 score. The index is calculated using the following formula: DAS28 = (0.56\*√\[TJC28\]) + (0.28\*√\[SJC28\]) + (0.70\*ln\[ESR\]) + (0.014\*VAS). Higher scores represent higher disease activity. Clinical remission = score \<2.6; Low disease activity = score ≥2.6 and ≤3.2; Moderate disease activity = score \> 3.2 and ≤5.1; High disease activity = score \>5.1.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here, n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (NUMBER)
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityBaseline: Clinical remission (n=56)0 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 2: Clinical remission (n=56)7.1 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 24: Clinical remission (n=42)64.3 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 52: Clinical remission (n=8)87.5 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityBaseline: Low disease activity (n=56)1.8 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 2: Low disease activity (n=56)16.1 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 24: Low disease activity (n=42)16.7 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 52: Low disease activity (n=8)0 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityBaseline: Moderate disease activity (n=56)35.7 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 2: Moderate disease activity (n=56)53.6 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 24: Moderate disease activity (n=42)19.0 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 52: Moderate disease activity (n=8)12.5 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityBaseline: High disease activity (n=56)62.5 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 2: High disease activity (n=56)23.2 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 24: High disease activity (n=42)0 percentage of participants
TocilizumabPercentage of Participants Achieving DAS28-ESR Remission, DAS28-ESR LDA, Moderate Disease Activity and High Disease ActivityWeek 52: High disease activity (n=8)0 percentage of participants
Secondary

Percentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease Activity

SDAI is calculated by simple arithmetical addition of TJC28 and SJC28, PGA VAS and Physician Global Assessment of disease activity VAS, and CRP concentration in mg/L. VAS range was 0=no disease activity to 100=maximum disease activity displayed on the 100-mm horizontal VAS. Total SDAI score ranges from 0 to 86 with higher scores indicating increased disease activity. Clinical remission = score ≤ 3.3; Low disease activity = score \> 3.3 and ≤ 11.0; Moderate disease activity = score \> 11.0 and ≤ 26.0; high disease activity = score \> 26.0.

Time frame: From Baseline to Week 2, Week 24 and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here, n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (NUMBER)
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 52: High disease activity (n=7)0 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityBaseline: Clinical remission (n=53)0 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 2: Clinical remission (n=55)1.8 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 24: Clinical remission (n=40)30.0 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 52: Clinical remission (n=7)42.9 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityBaseline: Low disease activity (n=53)0 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 2: Low disease activity (n=55)7.3 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 24: Low disease activity (n=40)40.0 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 52: Low disease activity (n=7)14.3 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityBaseline: Moderate disease activity (n=53)30.2 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 2: Moderate disease activity (n=55)54.5 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 24: Moderate disease activity (n=40)25.0 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 52: Moderate disease activity (n=7)42.9 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityBaseline: High disease activity (n=53)69.8 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 2: High disease activity (n=55)36.4 percentage of participants
TocilizumabPercentage of Participants Achieving SDAI Remission, SDAI LDA, Moderate Disease Activity and High Disease ActivityWeek 24: High disease activity (n=40)5.0 percentage of participants
Secondary

Percentage of Participants With Corticosteroid Dose Reduction/Discontinuation

Time frame: Up to Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here, number of participants analyzed signifies those participants who were evaluable for this outcome measure.

ArmMeasureValue (NUMBER)
TocilizumabPercentage of Participants With Corticosteroid Dose Reduction/Discontinuation50.0 percentage of participants
Secondary

Percentage of Participants With Positive American College of Rheumatology (ACR) Response Scores

The ACR core set of outcome measures and their definition of improvement includes a \>= 20% improvement (ACR20) compared to Baseline in both SJC and TJC as well as in three out of five additional parameters: Physician's Global Assessment of disease activity VAS, PGA VAS, patient's assessment of pain VAS, Health Assessment Questionnaire-Disability Index (HAQ-DI), and acute phase reactant (CRP or ESR). VAS range for all assessments was 0=no disease activity to 100=maximum disease activity displayed on the 100-mm horizontal VAS. Achievement of an ACR50 requires a \>= 50% improvement in the same parameters and an ACR70 requires a \>= 70% improvement.

Time frame: From Baseline to Week 2, Week 24, and Week 52

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here, n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (NUMBER)
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresBaseline: ACR 20 (n=55)0 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresWeek 2: ACR 20 (n=51)21.6 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresWeek 24: ACR 20 (n=39)84.6 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresWeek 52: ACR 20 (n=8)100 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresBaseline: ACR 50 (n=55)0 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresWeek 2: ACR 50 (n=52)1.9 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresWeek 24: ACR 50 (n=39)66.7 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresWeek 52: ACR 50 (n=8)62.5 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresBaseline: ACR 70 (n=55)0 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresWeek 2: ACR 70 (n=52)0 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresWeek 24: ACR 70 (n=39)38.5 percentage of participants
TocilizumabPercentage of Participants With Positive American College of Rheumatology (ACR) Response ScoresWeek 52: ACR 70 (n=8)25.0 percentage of participants
Secondary

Percentage of Participants With Responses According to European League Against Rheumatism (EULAR ) Criteria

EULAR response was calculated as the difference between DAS28-ESR scores at baseline and Week 24, and reported as the percentage of participants with good, moderate, or no response. Good responders = decrease from baseline \>1.2 with a DAS28 score of \<=3.2; moderate responders = decrease from baseline \>1.2 with a DAS28 score of \>3.2, or decrease from baseline \>0.6 to \<=1.2 with a DAS28 score of \<=5.1; non-responders = decrease from baseline \<=0.6 or decrease from baseline \>0.6 and \<=1.2 with a DAS28 score of \>5.1.

Time frame: From Baseline to Week 2, Week 24

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (NUMBER)
TocilizumabPercentage of Participants With Responses According to European League Against Rheumatism (EULAR ) CriteriaWeek 2: No response (n=56)32.1 percentage of participants
TocilizumabPercentage of Participants With Responses According to European League Against Rheumatism (EULAR ) CriteriaWeek 2: Good response (n=56)17.9 percentage of participants
TocilizumabPercentage of Participants With Responses According to European League Against Rheumatism (EULAR ) CriteriaWeek 24: Good response (n=42)76.2 percentage of participants
TocilizumabPercentage of Participants With Responses According to European League Against Rheumatism (EULAR ) CriteriaWeek 2: Moderate response (n=56)50.0 percentage of participants
TocilizumabPercentage of Participants With Responses According to European League Against Rheumatism (EULAR ) CriteriaWeek 24: Moderate response (n=42)19.0 percentage of participants
TocilizumabPercentage of Participants With Responses According to European League Against Rheumatism (EULAR ) CriteriaWeek 24: No response (n=42)4.8 percentage of participants
Secondary

Safety: Percentage of Participants With Adverse Events

An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.

Time frame: Up to 52 weeks

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab.

ArmMeasureValue (NUMBER)
TocilizumabSafety: Percentage of Participants With Adverse Events96.5 percentage of participants
Secondary

Safety: Percentage of Participants With Anti-tocilizumab Antibodies

Time frame: Baseline, Week 24

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here, n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (NUMBER)
TocilizumabSafety: Percentage of Participants With Anti-tocilizumab AntibodiesBaseline (n= 55)0 percentage of participants
TocilizumabSafety: Percentage of Participants With Anti-tocilizumab AntibodiesWeek 24 (n= 43)1.7 percentage of participants
Secondary

Treatment Satisfaction Questionnaire for Medication (TSQM ) Scores

The abbreviated 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9) derived from the TSQM Version 1.4 but without the five items of the side effects domain, is a reliable and valid measure to assess participants' satisfaction with treatment. The TSQM-9 domain scores range from 0 to 100 with higher scores representing higher satisfaction on that domain. Domains included are effectiveness, convenience and global satisfaction.

Time frame: Week 24

Population: The FAS consisted of all participants included in the study who received at least one dose of subcutaneous tocilizumab. Here n is the number of participants with evaluable data for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
TocilizumabTreatment Satisfaction Questionnaire for Medication (TSQM ) ScoresEffectiveness (n=46)66.7 Units on a scaleStandard Deviation 19.07
TocilizumabTreatment Satisfaction Questionnaire for Medication (TSQM ) ScoresConvenience (n=46)76.09 Units on a scaleStandard Deviation 15.66
TocilizumabTreatment Satisfaction Questionnaire for Medication (TSQM ) ScoresGlobal Satisfaction (n=46)65.06 Units on a scaleStandard Deviation 15.52

Source: ClinicalTrials.gov · Data processed: Feb 25, 2026