The impact of tocilizumab on anxiety and depression in patients with rheumatoid arthritis.

INTRODUCTION Mood disorders, such as anxiety and depression are extremely prevalent among patients with rheumatoid arthritis (RA). In this study we assessed the impact of treatment with tocilizumab (TCZ), an IL-6 antagonist, upon anxiety and depressive symptoms in a cohort of RA patients. METHODS Study participants were adults diagnosed with RA who received a weekly subcutaneous injection of tocilizumab for 24 weeks. We used the Hamilton Depression (HDRS) and Anxiety (HAMA) scores in order to assess the severity of depression and anxiety respectively. RA disease activity indices and depression and anxiety levels were assessed at baseline, 4 weeks and study completion. RESULTS Ultimately, 91 patients were included in the study. The mean age was 54 years and the majority were female (79%). The mean score in all disease activity indices as well as depression and anxiety levels decreased dramatically from baseline to study completion. Sixty patients (66%) demonstrated a significant decrease in anxiety and/or depression levels. When logistic regression was performed, an HDRS score indicative of depression at study baseline demonstrated an independent association with a significant psychiatric response whilst older age and increased baseline weight were negatively associated. HAMA and HDRA scores correlated with the following RA disease activity parameters respectively; HAQ-DI (r=0.4, 0.42), DAS28 (r=0.29, 0.32) and CDAI (0.28 and 0.33), all of them were statistically significant (p<0.01). CONCLUSIONS This study has demonstrated a favorable impact of TCZ therapy on parameters reflecting depression and anxiety severity in patients with RA.