Safety and effectiveness of tocilizumab treatment for rheumatoid arthritis

This study looked at the effectiveness and safety of tocilizumab (Actemra) in previously treated patients with rheumatoid arthritis (RA). The authors concluded that tocilizumab, used alone or as a combination therapy, was effective in patients who did not tolerate prior therapies.

Conventional disease-modifying anti-rheumatic drugs (DMARDS), such as methotrexate (Rheumatrex), are usually prescribed as a first treatment for RA. However, roughly one-third of patients will stop treatment. This is often due to serious side effects, frequently affecting the stomach or digestive system.

Many of these patients will switch to a biological therapy such as adalimumab (Humira) or tocilizumab. These treatments can be used on their own or in combination with DMARDs. The safety and effectiveness of tocilizumab in patients who did not tolerate a prior treatment is still being studied.

This study compared the use of tocilizumab alone and as a combination therapy to treatment with DMARDs in patients with RA. The authors combined data from 13 different clinical trials involving a total of 6,679 patients. The most common DMARD used was methotrexate.

Disease remission (no evidence of disease) was 21% higher in patients treated with combination therapy than in those treated with tocilizumab alone. Patients treated with combination therapy were 14% more likely to see a significant improvement in their condition.

The risk of serious side effects was 40% higher in patients treated with combination therapy compared to tocilizumab alone.

Treatment with either tocilizumab alone or combination therapy was more effective than continuing with DMARD therapy. 

The authors concluded that tocilizumab, either alone or as a combination therapy, is an effective alternative treatment to DMARDs. Tocilizumab combination therapy was overall more effective, but caused more serious side effects. 

The data reported was calculated by combining results from many studies. These studies compared different types of DMARDS with different doses.

If you are having trouble tolerating a conventional DMARD, consult with your physician to discuss potential alternatives.