In a nutshell
This study compared the effectiveness of abatacept (Orencia) and tocilizumab (Actemra) in patients with rheumatoid arthritis (RA) who had previously taken anti TNF therapy. The authors concluded that both of these drugs led to a significant improvement in disease activity in both treatment groups.
Some background
In RA, the immune system attacks the healthy joints the way it would a virus or bacteria. Biological drugs are commonly prescribed for the treatment of RA. Anti-tumor necrosis factor (TNF) therapy such as etanercept (Enbrel) is often the first type of biological treatment to be prescribed. However, many patients do not respond to anti TNF therapy and may need to switch to another type of biological treatment.
Abatacept and tocilizumab are two other types of biological treatment that may be taken. Abatacept works by blocking the activity of cells that contribute to inflammation in RA. Tocilizumab blocks the activity of a protein that can cause inflammation. It is not known if one of these drugs is more effective than the other in patients who have not responded to anti TNF therapy in the past.
Methods & findings
264 pairs of RA patients were matched based on their previous treatment and medical history. One patient in each pair received abatacept treatment and the other received tocilizumab treatment. Changes in disease activity, achieving low disease activity or remission, and a patient self-assessment of their health were measured after 6 months of treatment.
A decrease in disease activity of 6.5 would be regarded as a moderate improvement for RA patients. Both treatments were associated with a similar improvement in disease activity. Disease activity decreased by 11.3 for abatacept treatment and by 9.9 for tocilizumab treatment.
Low disease activity or remission was seen in one third of patients in both groups. Patients in both groups reported similar improvements in their health.
A small number of patients developed cancer, serious infection, or cardiovascular disease (affecting the heart and blood vessels) during the study. No significant differences were observed between treatment groups.
The bottom line
This study concluded that both abatacept and tocilizumab are effective treatment options for patients with RA who have previously been unresponsive to anti TNF therapy.
The fine print
Some of the authors have received funding from drug companies that produce the treatments used in this study.
Published By :
Arthritis Research & Therapy
Date :
Dec 01, 2016
