Predictors of achieving remission in rheumatoid arthritis during levilimab therapy in real-world clinical practice

Abstract

Objective: to identify possible predictors of achieving remission in patients with rheumatoid arthritis (RA) during levilimab (LVL) therapy in realworld clinical practice.

Material and methods. In a retrospective observational study conducted at the G.G. Kuvatov Republican Clinical Hospital (Ufa) from January 2023 to January 2025, the efficacy of LVL therapy was assessed over time using clinical and laboratory parameters at weeks 12, 24, 52, and 104 after treatment initiation. The analysis included 37 patients with RA (30 women and 7 men; mean age 43±12.6 years).

Results and discussion. Mean DAS28-CRP and DAS28-ESR values at LVL initiation were 6.6±0.8 and 6.9±0.8, respectively. By the end of follow-up, all 37 patients achieved remission according to at least one criterion: DAS28-CRP, DAS28-ESR, CDAI, or SDAI. Multiple linear regression analysis identified factors influencing RA activity according to DAS28-CRP at week 104. Age (p=0.005), disease duration since RA diagnosis (p=0.014), fatigue severity (p=0.022), and patient global assessment of disease activity on the visual analog scale (VAS; p=0.017) had a statistically significant positive effect on the final DAS28-CRP value. The greatest negative impact was exerted by pain intensity on VAS (p=0.001). A favorable safety profile of LVL was noted.

Conclusion. Age, disease duration since RA diagnosis, fatigue severity, patient global assessment of disease activity, and pain intensity on VAS are the most significant prognostic criteria for achieving remission in patients with RA receiving LVL.