Clinical and laboratory efficacy of levilimab therapy in patients with rheumatoid arthritis in real-world clinical practice
Abstract. Rheumatoid arthritis (RA) is an immune-inflammatory rheumatic disease requiring timely biologic therapy. Levilimab is an original interleukin 6 receptor inhibitor approved for RA treatment. The aim: to evaluate the effect of levilimab on RA course in real-world clinical practice. Material and methods. A single-centre observational study enrolled 147 RA patients (women – 82.3%) receiving levilimab at a Biologic Therapy Centre. Median age was 60 [47; 65] years, disease duration – 108 [57; 204] months. Observation period was 3 months. Results. After 3 months of levilimab therapy, statistically significant reductions in DAS28ESR (from 5.37 ± 0.73 to 3.46 ± 0.88; p <0.001), DAS28CRP (from 5.49 ± 0.82 to 3.57 ± 0.89; p <0.001), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level were observed. Complete glucocorticoid (GC) discontinuation was achieved in 27 (32.5%) of 83 patients (p <0.001). Combination therapy (levilimab + conventional synthetic DMARDs) provided greater disease activity reduction and higher remission rate (10.3 vs 0%; p = 0.017) compared to levilimab monotherapy. Results are consistent with AURORA, SOLAR and HELIOS data. The steroid-sparing effect aligns with current guidelines recommending GC minimization. Conclusion. Levilimab demonstrated high efficacy in real-world practice: rapid RA activity reduction, steroid-sparing effect, and applicability across all lines of biologic therapy.V.I. Mazurov, E.S. Melnikov, E.A. Trofimov, O.V. Inamova, R.R. Samigullina, A.L. Chudinov, D.B. Aliev, K.P. Morozova
Keywords
rheumatoid arthritis
levilimab
interleukin 6 receptor inhibitor
biologic disease-modifying antirheumatic drugs
real-world practice
DAS28
glucocorticoids
comorbidity
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About the Authors
Vadim I. Mazurov, MD, Dr. Sci. (Medicine), professor, academician of RAS, Honored Worker of Science of the Russian Federation, vice president of RSMSIM, principal scientific advisor and director of the Research Institute of Rheumatology, head of the Department of therapy and rheumatology named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University; head of Autoimmune Center, V.A. Nasonova Clinical Rheumatology Hospital No. 25; chief freelance specialist – rheumatologist of the Healthcare Committee of the Government of Saint Petersburg, Saint Petersburg, Russian Federation.E-mail: maz.nwgmu@yandex.ru
ORCID: https://orcid.org/0000-0002-0797-2051. Scopus ID: 16936315400. eLibrary SPIN: 6823-5482
Evgeny S. Melnikov, MD, PhD (Medicine), assistant at the Department of therapy and rheumatology named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University; rheumatologist at V.A. Nasonova Clinical Rheumatology Hospital No. 25, Saint Petersburg, Russian Federation.
E-mail: emelnikov@euat.ru
ORCID: https://orcid.org/0000-0002-8521-6542. eLibrary SPIN: 4544-0596
Evgeny A. Trofimov, MD, Dr. Sci. (Medicine), associate professor, scientific secretary, deputy director of the Research Institute of Rheumatology, head of the Department of therapy and rheumatology named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University, Saint Petersburg, Russian Federation.
E-mail: Evgeniy.trofimov@szgmu.ru
ORCID: https://orcid.org/0000-0003-3236-4485. Scopus ID: 57082588900. eLibrary SPIN: 4358-1663
Oksana V. Inamova, MD, PhD (Medicine), deputy director of the Research Institute of Rheumatology, assistant at the Department of therapy and rheumatology named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University; chief medical officer of V.A. Nasonova Clinical Rheumatology Hospital No. 25, Saint Petersburg, Russian Federation.
E-mail: ovig74@mail.ru
ORCID: https://orcid.org/0000-0001-9126-3639. eLibrary SPIN: 8841-5496
Ruzana R. Samigullina, MD, PhD (Medicine), associate professor of the Department of therapy and rheumatology named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University; rheumatologist, head of the City Center for Biologic Therapy, V.A. Nasonova Clinical Rheumatology Hospital No. 25, Saint Petersburg, Russian Federation.
E-mail: dr.samigullina@yandex.ru
ORCID: https://orcid.org/0000-0002-6341-3334
Anton L. Chudinov, MD, PhD (Medicine), assistant at the Department of therapy and rheumatology named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University; deputy chief medical officer of V.A. Nasonova Clinical Rheumatology Hospital No. 25, Saint Petersburg, Russian Federation.
E-mail: anton-chudinov@mail.ru
ORCID: https://orcid.org/0000-0002-7675-5683. eLibrary SPIN: 5771-8320
Damir B. Aliev, MD, PhD (Medicine), rheumatologist at V.A. Nasonova Clinical Rheumatology Hospital No. 25, Saint Petersburg, Russian Federation.
E-mail: rv-aliev88@mail.ru
ORCID: https://orcid.org/0000-0001-8367-4622. Scopus ID: 57873750600. eLibrary SPIN: 6068-4966
Kira P. Morozova, MD, postgraduate student of the Department of therapy and rheumatology named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University; rheumatologist at V.A. Nasonova Clinical Rheumatology Hospital No. 25, Saint Petersburg, Russian Federation
E-mail: kiramoroz194@gmail.com
ORCID: https://orcid.org/0000-0002-4113-3104
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