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Sarilumab may improve RA symptoms regardless of prior treatment response

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Sarilumab improved symptoms of rheumatoid arthritis and hindered structural damage and disease progression irrespective of prior biologic treatment experience in patients with active disease and poor response to methotrexate, according to recent study findings.

Researchers compared the response of 318 patients with no prior use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) who received 150 mg sarilumab plus methotrexate, 321 bDMARD-naïve patients who received 200 mg sarilumab and methotrexate, and 318 patients who received placebo plus methotrexate with patients who had a prior history of inadequate response to bDMARDs. In addition to methotrexate, 82 of the latter group of patients received 150 mg sarilumab, 78 patients received 200 mg sarilumab and 82 patients received placebo. Anti-tumor necrosis factor-alpha (anti-TNF) agents were taken previously by 44 of the patients receiving 150 mg sarilumab, 58 patients who received 200 mg sarilumab and 51 of patients who received placebo. Doses were received every 2 weeks, and patients were assessed at 24 weeks and 52 weeks.

Désirée van der Heijde

Smaller numerical mean increases in the modified Total Sharp Score (mTSS) were seen in joint space narrowing (JSN) and erosion in patients who received sarilumab compared with placebo, regardless of prior biologic use status. At 52 weeks, fewer patients who received sarilumab showed radiographic progression compared with placebo, and patients who had radiographic progression had changes in mTSS, erosion and JSN, showing that patients who received sarilumab had less progression compared with placebo, according to the researchers.

Statistically significant improvements in American College of Rheumatology 20% improvement criteria (ACR20), ACR50, ACR70 and other measurements of response to treatment were seen in all patients who received sarilumab regardless of prior treatment history at week 24, and improvements were maintained through week 52. Patients with prior anti-TNF experience showed similar results, the researchers reported.

Treatment-emergent adverse events included infections, neutropenia, injection-site reactions and increases in transaminases regardless of prior experience with prior biologic therapy. – by Shirley Pulawski

Reference:

van der Heijde D, et al. Paper #SAT0185. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.

Disclosure s: van der Heijde reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.