{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:10:48Z","timestamp":1775693448385,"version":"3.50.1"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T00:00:00Z","timestamp":1576281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T00:00:00Z","timestamp":1576281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"name":"Roche Tunisia SA"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2020,5]]},"DOI":"10.1007\/s10067-019-04815-8","type":"journal-article","created":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T17:02:25Z","timestamp":1576342945000},"page":"1449-1455","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Safety and efficacy of tocilizumab as monotherapy or in combination with methotrexate in Tunisian patients with active rheumatoid arthritis and inadequate response to disease-modifying anti-rheumatic drugs in conditions close to clinical practice"],"prefix":"10.1007","volume":"39","author":[{"given":"Elyes","family":"Bouajina","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leith","family":"Zakraoui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Montassar","family":"Kchir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Kochbati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofiene","family":"Baklouti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,12,14]]},"reference":[{"key":"4815_CR1","unstructured":"World Health Organisation (WHO). Fact sheet. Available at: http:\/\/www.who.int\/chp\/topics\/rheumatic\/en\/. Accessed June 2018"},{"issue":"3","key":"4815_CR2","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1093\/rheumatology\/ket446","volume":"53","author":"S Slimani","year":"2014","unstructured":"Slimani S, Ladjouze-Rezig A (2014) Prevalence of rheumatoid arthritis in an urban population of Algeria: a prospective study. Rheumatology (Oxford) 53(3):571\u2013573","journal-title":"Rheumatology (Oxford)"},{"key":"4815_CR3","doi-asserted-by":"publisher","first-page":"2451","DOI":"10.2146\/ajhp050514","volume":"63","author":"A Gaffo","year":"2006","unstructured":"Gaffo A, Saag KG, Curtis JR (2006) Treatment of rheumatoid arthritis. Am J Health Syst Pharm 63:2451\u20132465","journal-title":"Am J Health Syst Pharm"},{"key":"4815_CR4","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1056\/NEJM200011303432201","volume":"343","author":"JM Bathon","year":"2000","unstructured":"Bathon JM, Martin RW, Fleischmann RM et al (2000) A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis. N Engl J Med 343:1586\u20131593","journal-title":"N Engl J Med"},{"key":"4815_CR5","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.1002\/1529-0131(199809)41:9<1552::AID-ART5>3.0.CO;2-W","volume":"41","author":"RN Maini","year":"1998","unstructured":"Maini RN, Breedveld FC, Kalden JR et al (1998) Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor alpha monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritis. Arthritis Rheum 41:1552\u20131563","journal-title":"Arthritis Rheum"},{"key":"4815_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/acr.22783","volume":"68","author":"JA Singh","year":"2016","unstructured":"Singh JA, Saag KG, Bridges SL Jr et al (2016) American College of Rheumatology Guideline for the treatment of rheumatoid arthritis. Arthritis Care Res 68:1\u201325","journal-title":"Arthritis Care Res"},{"key":"4815_CR7","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1136\/annrheumdis-2016-210715","volume":"76","author":"JS Smolen","year":"2017","unstructured":"Smolen JS, Landewe R, Bijlsma J et al (2017) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease modifying antirheumatic drugs: 2016 update. Ann Rheum Dis 76:960\u2013997","journal-title":"Ann Rheum Dis"},{"issue":"5","key":"4815_CR8","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1177\/1759720X10378372","volume":"2","author":"S Srirangan","year":"2010","unstructured":"Srirangan S, Choy EH (2010) The role of interleukin 6 in the pathophysiology of rheumatoid arthritis. Ther Adv Musculoskelet 2(5):247\u2013256","journal-title":"Ther Adv Musculoskelet"},{"issue":"2","key":"4815_CR9","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1080\/14397595.2018.1546357","volume":"29","author":"A Ogata","year":"2019","unstructured":"Ogata A, Kato Y, Higa S, Yoshizaki K (2019) IL-6 inhibitor for the treatment of rheumatoid arthritis: a comprehensive review. Mod Rheumatol 29(2):258\u2013267","journal-title":"Mod Rheumatol"},{"key":"4815_CR10","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1007\/978-3-540-73259-4_7","volume":"181","author":"N Nishimoto","year":"2008","unstructured":"Nishimoto N, Kishimoto T (2008) Humanized antihuman IL-6 receptor antibody, tocilizumab. Handb Exp Pharmacol 181:151\u2013160","journal-title":"Handb Exp Pharmacol"},{"key":"4815_CR11","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s40744-018-0102-x","volume":"5","author":"A Rubbert-Roth","year":"2018","unstructured":"Rubbert-Roth A, Furst DE, Nebesky JM, Jin A, Berber E (2018) A review of recent advances using tocilizumab in the treatment of rheumatic diseases. Rheum Ther 5:21\u201342","journal-title":"Rheum Ther"},{"issue":"12","key":"4815_CR12","doi-asserted-by":"publisher","first-page":"1950","DOI":"10.1136\/annrheumdis-2011-201087","volume":"71","author":"VP Bykerk","year":"2012","unstructured":"Bykerk VP, Ost\u00f6r AJK, Alvaro-Gracia J et al (2012) Tocilizumab in patients with active rheumatoid arthritis and inadequate responses to DMARDs and\/or TNF inhibitors: a large, open-label study close to clinical practice. Ann Rheum Dis 71(12):1950\u20131954","journal-title":"Ann Rheum Dis"},{"issue":"1","key":"4815_CR13","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3899\/jrheum.100717","volume":"38","author":"JA Singh","year":"2011","unstructured":"Singh JA, Beg S, Lopez-Olivo MA (2011) Tocilizumab for rheumatoid arthritis: a Cochrane systematic review. J Rheumatol 38(1):10\u201320","journal-title":"J Rheumatol"},{"issue":"6","key":"4815_CR14","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.semarthrit.2009.12.002","volume":"39","author":"GJD Bergman","year":"2010","unstructured":"Bergman GJD, Hochberg MC, Boers M, Wintfeld N, Kielhorn A, Jansen JP (2010) Indirect comparison of tocilizumab and other biologic agents in patients with rheumatoid arthritis and inadequate response to disease-modifying antirheumatic drugs. Semin Arthritis Rheum 39(6):425\u2013444","journal-title":"Semin Arthritis Rheum"},{"issue":"6","key":"4815_CR15","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1002\/art.40084","volume":"69","author":"SC Kim","year":"2017","unstructured":"Kim SC, Solomon DH, Rogers JR et al (2017) Cardiovascular safety of tocilizumab versus tumor necrosis factor inhibitors in patients with rheumatoid arthritis: a multi-database cohort study. Arthritis Rheum 69(6):1154\u20131164","journal-title":"Arthritis Rheum"},{"issue":"2","key":"4815_CR16","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1002\/art.38920","volume":"67","author":"VU Rao","year":"2015","unstructured":"Rao VU, Pavlov A, Klearman M et al (2015) An evaluation of risk factors for major adverse cardiovascular events during tocilizumab therapy. Arthritis Rheum 67(2):372\u2013380","journal-title":"Arthritis Rheum"},{"issue":"1","key":"4815_CR17","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1186\/s13075-015-0880-2","volume":"17","author":"V Strand","year":"2015","unstructured":"Strand V, Ahadieh S, French J et al (2015) Systematic review and meta-analysis of serious infections with tofacitinib and biologic disease-modifying antirheumatic drug treatment in rheumatoid arthritis clinical trials. Arthritis Res Ther 17(1):362","journal-title":"Arthritis Res Ther"}],"container-title":["Clinical Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-019-04815-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s10067-019-04815-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-019-04815-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T00:22:37Z","timestamp":1607818957000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s10067-019-04815-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,14]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["4815"],"URL":"https:\/\/doi.org\/10.1007\/s10067-019-04815-8","relation":{},"ISSN":["0770-3198","1434-9949"],"issn-type":[{"value":"0770-3198","type":"print"},{"value":"1434-9949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,14]]},"assertion":[{"value":"26 May 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 September 2019","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 October 2019","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 December 2019","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"None.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"The study was conducted according to the Declaration of Helsinki and the International Committee on Harmonisation Good Clinical Practice guidelines, together with the applicable laws in Tunisia. The protocol was reviewed and approved by regulatory authorities as well as the appropriate independent ethics committees of each participating centre.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All patients provided written informed consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement of informed consent"}}]}}