In a nutshell
This study investigated the effect of tocilizumab (Actemra) on disease-progression in young patients with systemic juvenile idiopathic arthritis (sJIA) and polyarticular-course juvenile idiopathic arthritis (pcJIA).
The data showed that tocilizumab may slow down the progression of sJIA and pcJIA in digital imaging.
Some background
In many cases, when children develop symptoms of arthritis before the age of 16, the cause remains unknown. It is referred to as juvenile idiopathic arthritis (JIA). The symptoms and test results will also determine the specific subtype. Systemic JIA (sJIA) is diagnosed if the child shows signs of inflammation in the whole body. Symptoms can be signs of inflammation in organs, a fever and/or rash. Polyarticular-course JIA (pcJIA) is diagnosed if more than 4 joints show inflammatory signs like swelling and pain within the first 6 months of the illness.
The current state and progression of the disease in the joints themselves can be verified by the means of digital imaging (DI) like MRI. Standardized methods are used to evaluate and interpret the images of the joints. The treatment to slow down the progression of the disease and decrease symptoms include drugs like tocilizumab. Tocilizumab blocks the inflammation-causing protein IL6 with the goal to ease the symptoms.
Previous studies showed that tocilizumab reduces the progression of rheumatoid arthritis (RA) on DI in adults. There is not yet an evaluation of the data on how the drug affects the progression of the disease in DI in children with JIA.
Methods & findings
This study evaluated the data of two different studies investigating tocilizumab in children with JIA.One study involved 112 patients with sJIA treated with tocilizumab. The second study involved 188 patients with pcJIA. It compared a group receiving a placebo to a group receiving tocilizumab over a period of 24 weeks. In both studies, DI of hands and wrists was performed within the first 4 weeks, after an average of 52 weeks, and after an average of 104 weeks.
Patients with sJIA who received tocilizumab did not show any progression at 52 and 104 weeks. Patients with pcJIA who received tocilizumab also did not show any significant progression.
The bottom line
The authors found that tocilizumab may slow down the progression of sJIA and pcJIA in joints.
The fine print
This study was sponsored by the pharmaceutical company F. Hoffmann-La Roche Ltd., the manufacturer of tocilizumab.
Published By :
Arthritis Research & Therapy
Date :
Sep 10, 2020
