Fresh Hope For Thousands Of Rheumatoid Arthritis (RA) Sufferers Who Cannot Tolerate The Most Common Treatment For This Debilitating DiseaseMain Category: Arthritis / Rheumatology
Article Date: 21 Mar 2013
Head to head data in The Lancet confirms RoActemra® (tocilizumab) is superior to Humira® (adalimumab) in achieving disease remission when either is used without methotrexate (MTX)
Data published this week in The Lancet show that over 50% of RA patients can achieve low disease activity or remission with RoActemra, compared to under 20% of those treated with the most widely prescribed anti-TNF Humira when neither drug is combined with methotrexate (51.5% vs. 19.8%, assessed by DAS28 less than or equal to 3.2*). The study exposed a wealth of data indicating the superiority of RoActemra over Humira, with almost four times as many patients achieving disease remission with RoActemra alone, compared to Humira alone (39.9% vs. 10.5%, assessed by DAS28 <2.6*) and almost twice as many patients achieve a 70% improvement in the signs and symptoms of their disease (32.5% vs. 17.9%, assessed by ACR70**).1
The study findings offer hope to RA patients that RoActemra without methotrexate is an efficacious treatment which can provide tight disease control to those who cannot tolerate methotrexate. RA patients are often treated with a number of medicines, combining methotrexate, the current standard of care for RA patients across the UK, with a biologic therapy. However, it is estimated that approximately one third of patients cannot tolerate methotrexate, due to the side effects including nausea and vomiting, diarrhoea, mouth ulcers, skin conditions, such as redness of the skin, itching and even hair loss.1, 2, 3, 4, 5, 6
RoActemra, which is directed at a different aspect of the immune response compared to other biologic treatments, targets the interleukin-6 (IL-6) receptor, which is one of the main causes of inflammation, fatigue, anaemia and joint damage in RA. By blocking IL-6 and disrupting the signalling pathway, it reduces the cascade of inflammation, supressing the systemic and local RA symptoms and preventing the progression of the disease in the joints and through-out the body. 7, 8
"RA is a progressive, debilitating disease which can have a serious impact on a person's life and the side effects of treatment can further compound this, so these data are particularly relevant for those who cannot take methotrexate" said Professor John Isaacs, Consultant Rheumatologist and ADACTA Study Investigator. "Remission is the ultimate goal of treatment in RA because until a patient has reached this, further joint damage can occur. As the first study of its kind which shows the superiority of one RA therapy over another in the monotherapy setting, these data will be of great interest to physicians and patients alike" he commented.
It is essential that patients achieve disease remission, because even if they are not suffering disease symptoms, long-term joint damage is occurring, which can result in the need for joint replacement surgeries, an increased chance of deformities or perhaps even becoming wheelchair bound. 9, 10
RoActemra therapy has an established safety profile as demonstrated in over 125,691 patient years.11 The most common adverse reactions reported in clinical studies were upper respiratory tract infection, nasopharyngitis, headache, elevated blood pressure, and increased liver enzymes. The serious adverse reactions reported in clinical studies include serious infections, gastrointestinal perforations and hypersensitivity reactions including anaphylaxis.12 Within the ADACTA study, the adverse event profile was comparable across RoActemra and Humira.1
* The Disease Activity Score (DAS)28 is a combined index that measures disease activity in patients with RA. It combines information from 28 tender and swollen joints (0-28), erythrocyte sedimentation rate, and a general health assessment on a visual analogue scale. The level of disease activity is interpreted as low (DAS28 ≤3.2), moderate (DAS28 3.2-5.1) or high (DAS28>5.1). DAS28<2.6 corresponds to being in remission according to the criteria of the American College of Rheumatology
** ACR70 represents a 70% reduction in certain RA symptoms, including the number of tender and swollen joints, pain, patient's and physician's global assessments and certain laboratory markers
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