In a nutshell
This study compared the safety and effectiveness of treatment with tocilizumab (TCZ, Actemra) on its own or in combination with methotrexate (MTX, Trexall) in rheumatoid arthritis (RA) patients who have a poor response to MTX. The study concluded that TCZ and MTX together were more effective than TCZ alone
Some background
The treatment goal in RA is to treat the disease early and aggressively in order to reduce symptoms and to prevent joint damage. MTX is usually the first drug used to treat RA as it is very effective and safe. However, MTX is not effective in all patients, and other drugs must be considered.
TCZ is also an effective treatment for RA. It is effective in patients who respond poorly to MTX and in patients who either have been treated with MTX before, or who have never been treated with MTX. Whether TCZ combined with MTX is more effective than switching from MTX to TCZ is unclear.
Methods & findings
In this study, 223 patients were randomly assigned to one of two groups. Group1 was treated with TCZ and MTX. Patients in group 2 switched from MTX to treatment with TCZ alone. All patients received 8 mg/kg of TCZ every 4 weeks.
At week 24, 70% of group 1 achieved remission (no symptoms), compared with 55% of group 2. By week 52, remission rates were similar for group 1 (72%) and group 2 (70%). Structural damage progression was seen in 7% of group 1 and 15% of group 2.
Group 1 experienced more infections and upset stomachs.
The bottom line
The study concluded that a combination of TCZ with MTX more quickly reduced inflammation and disease progression than TCZ alone.
What’s next?
Discuss with your doctor whether a combination of treatments would be more effective.
Published By :
Annals of the rheumatic diseases
Date :
Jan 05, 2016
