Optimizing Tocilizumab Treatment for Rheumatoid Arthritis

Concentration-guided Dose Reduction Versus Standard Dosing in Tocilizumab-treated Rheumatoid Arthritis Patients: a Randomised, Multicenter, Non-inferiority Trial (TODORA)

Phase 4 Interventional Reade Rheumatology Research Institute · NCT03895879

This study is testing if people with rheumatoid arthritis can safely take their tocilizumab medication every two weeks instead of weekly without it affecting how well it works.

Quick facts

PhasePhase 4
Study typeInterventional
Enrollment98 (estimated)
Ages18 Years and up
SexAll
SponsorReade Rheumatology Research Institute Academic / other
Drugs / interventionstocilizumab, methotrexate
Locations1 site (Amsterdam)
Trial IDNCT03895879 on ClinicalTrials.gov

What this trial studies

This clinical trial investigates whether patients with rheumatoid arthritis (RA) who have high serum levels of tocilizumab can safely extend their dosing interval from weekly to every two weeks without losing clinical effectiveness. The study will involve a 52-week multicenter, randomized controlled design, where participants will be assigned to either continue their standard weekly dose or switch to the extended dosing schedule. The primary goal is to assess the impact on disease activity while potentially reducing medication costs and minimizing the risk of adverse effects associated with overtreatment.

Who should consider this trial

Good fit: Ideal candidates are adults diagnosed with rheumatoid arthritis who have been on a stable dose of subcutaneous tocilizumab for at least six months.

Not a fit: Patients who are scheduled for surgery or have had recent changes in their glucocorticoid or DMARD treatment may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could lead to more personalized treatment plans for RA patients, reducing unnecessary medication costs and side effects.

How similar studies have performed: Previous studies have indicated that therapeutic drug monitoring can effectively optimize treatment regimens, suggesting potential success for this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Rheumatoid arthritis according to the American College of Rheumatology (ACR) 1987 or 2010 criteria;
* Current use of subcutaneous tocilizumab 162 mg weekly, for at least the previous 6 months;
* The treating rheumatologist is convinced of the benefit of tocilizumab continuation;
* Written informed consent.

Exclusion Criteria:

* A scheduled surgery in the next 52 weeks or other pre-planned reasons for treatment discontinuation;
* Changes in the treatment with glucocorticoids and DMARDs such as methotrexate in the past three months.

Where this trial is running

Amsterdam

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Rheumatoid ArthritisTocilizumabTherapeutic Drug MonitoringDrug levelDose reduction
Last reviewed 2026-06-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.