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Immediate treatment with tocilizumab found more effective than standard treatment for RA
Investigators of this study found immediate treatment of early rheumatoid arthritis with tocilizumab alone or with methotrexate to achieve readmission is more effective than the standard methotrexate treatment.
Researchers performed a multicenter, randomized, double-blind, double-dummy study on 317 patients with rheumatoid arthritis in the Netherlands at 21 rheumatology outpatient departments. Investigators randomized 106 patients to receive tocilizumab plus methotrexate, 103 patients to receive tocilizumab plus placebo methotrexate and 108 patients to receive methotrexate plus placebo tocilizumab. If readmission was not achieved, treatment was switched from the placebo to active treatment.
The primary endpoint was the proportion of patients who sustained readmission with initial treatment throughout the entire study and this was compared among treatment groups with the two-sided Cochran-Mantel-Haenzel test. Investigators based the analysis on an intention-to-treat method.
Results showed adverse events or intercurrent illness and insufficient response were the most frequent reasons for patients to dropout, with dropout rates of 27 patients and 26 patients, respectively. Investigators noted of 106 patients, 91 patients treated with tocilizumab plus methotrexate sustained readmission during initial treatment vs. 86 patients who were treated with tocilizumab and 48 patients who were treated with methotrexate.
For the entire study, researchers found overall readmission was sustained in 91 of the 106 patients treated with tocilizumab plus methotrexate, in 91 patients treated with tocilizumab and 83 patients treated with methotrexate. For all treatment groups, the most common adverse event was nasopharyngitis. The condition was seen in 38 patients treated with tocilizumab plus methotrexate, 40 patients treated with tocilizumab and 37 treated with methotrexate. Treatment groups were not significantly different with regard to the occurrence of serious adverse events. ‒ by Monica Jaramillo
Disclosures: Bijlsma reports he receives grants and fees from Roche, AbbVie, Brystol-Myers Squibb, Merck Sharp & Dohme, Pfizer and UCB. Please see the full study for a list of all other authors’ relevant financial disclosures.