Forced change in rheumatoid arthritis treatment due to COVID-19 pandemic: Effects of the switch from intravenous tocilizumab to subcutaneous form.

INTRODUCTION: Rheumatoid arthritis (RA) is one of the most common chronic systemic autoimmune diseases that primarily affecting the synovial joints, causing progressive joint disability and involving extra-articular symptoms. The American College of Rheumatology (ACR) criteria published in 2010 are used for the diagnosis and classification of RA. The aim of RA treatment is to achieve remission or low disease activity. For this purpose, steroids, non-steroidal anti-inflammatory drugs, conventional synthetic and biological DMARDs are used.
METHODS: Fifty-six RA patients whose drug was switched from the iv tocilizumab form to the subcutaneous form in the Department of Internal Medicine Rheumatology-Immunology at Çukurova University Faculty of Medicine Research Hospital were included in the study. RA patients were diagnosed according to the criteria published by the 2010 American College of Rheumatology. The data were analyzed retrospectively.
RESULTS: Forty seven patients had initially received iv tocilizumab treatment. The baseline mean DAS28 values were 7,65 and the mean treatment duration was 24.6 months. The mean DAS28 values in the 3rd month of the patients who received iv tocilizumab treatment at baseline were 3,6. The decrease in DAS-28 from baseline was statistically significant (p˂0,0001)
DISCUSSION AND CONCLUSION: Consequently, subcutaneous tocilizumab therapy was effective and safe as IV therapy. The number of hospital admissions was less in the subcutan group and COVID-19 infection was less common. Subcutaneous therapy is a good alternative, especially during the pandemic period when patients can not easily access IV therapy and need to be isolated from the hospital.