Vol.:(0123456789) 1 3 Rheumatology International https://doi.org/10.1007/s00296-020-04596-3 OBSERVATIONAL RESEARCH Patient satisfaction and clinical efectiveness of switching from intravenous tocilizumab to subcutaneous tocilizumab in patients with juvenile idiopathic arthritis: an observational study Nuray Aktay Ayaz 1  · Şerife Gül Karadağ 2  · Rahime Koç 2  · Fatma Gül Demirkan 2  · Figen Çakmak 1  · Hafze Emine Sönmez 2 Received: 1 April 2020 / Accepted: 4 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020 Abstract Introduction Juvenile idiopathic arthritis (JIA) is a heterogeneous group of idiopathic infammatory arthritis afecting chil- dren younger than 16 years of age. Tocilizumab (TCZ) is a humanized anti-interleukin 6 (IL-6) receptor antibody that was approved for systemic and polyarticular JIA patients. However, the studies regarding patients’ satisfaction while receiving TCZ therapy is scarce. Herein, we aimed to evaluate the efect of subcutaneous (SC) TCZ administration on patient satisfac- tion and disease control of JIA patients. Methods All JIA patients receiving TCZ were included in the study. Clinical features, laboratory fndings and JADAS71 scores were recorded at baseline and every 3 months during follow-up. Nine of the patients on intravenous (IV) TCZ treat- ment were switched to SC form. All patients receiving TCZ-SC were questioned by a clinical nurse specialist (CNS) to assess patient satisfaction. Results A total of 39 patients receiving TCZ were included in the study. Among them, treatment of nine patients (fve female, four male) was switched to SC form with a median of 11.5 (8–69) months after initiation of TCZ. Patients were stable both clinically and in laboratory means at the 3rd month of TCZ-SC treatment. There was no deterioration in terms of active joint counts, physician’s VAS, patient’s VAS and JADAS71. According to patient satisfaction questionnaire, eight of the patients felt satisfed with SC administrations in terms of life quality, school success and reduced school absenteeism. However, one patient did not agree that the SC form is as efective as IV form and wanted to continue with IV form. Conclusion TCZ is an efective treatment option in JIA and switching from IV to SC route when necessary is found to be an efective and acceptable alternative by the patients as well. Keywords Tocilizumab · Patient satisfaction · Subcutaneous Introduction Juvenile idiopathic arthritis is a heterogeneous group of disease characterized by arthritis of unknown origin with onset before age of 16 years. The major target of JIA treat- ment is hindering long-term disabilities by overcoming the ongoing infammation. Conventional treatment of JIA includes non-steroidal anti-infammatory drugs (NSAIDs), corticosteroids, and disease modifying anti-rheumatic drugs (DMARDs) such as methotrexate, sulfasalazine and lefuno- mide [1, 2]. Even though, DMARDs are still the frst line treatments [2, 3], some patients could not achieve remission with DMARDs and in the presence of inadequate response, biologic agents (BA) emerge as an alternative [1, 2]. Rheumatology INTERNATIONAL Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00296-020-04596-3) contains supplementary material, which is available to authorized users. * Nuray Aktay Ayaz nurayaktay@gmail.com 1 Department of Pediatric Rheumatology, Istanbul University Medical School, Fatih, Istanbul, Turkey 2 Department of Pediatric Rheumatology, Kanuni Sultan Süleyman Research and Training Hospital, University of Health Sciences, Istanbul, Turkey