RESEARCH - Tocilizumab benefits patients with refractory RA

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Tocilizumab Benefits Patients With Refractory Rheumatoid Arthritis

By Will Boggs, MD

NEW YORK (Reuters Health) Oct 18 - Treatment with the interleukin-6 receptor

antagonist tocilizumab improves outcomes in patients with rheumatoid

arthritis (RA) that responds only incompletely to methotrexate, according to

a report in the September issue of Arthritis & Rheumatism.

" Actemra [tocilizumab] has the potential to be a new option to patients and

physicians in combating their RA, " MacLean from Roche

Pharmaceuticals, Basel, Switzerland told Reuters Health.

Dr. R. N. Maini from Imperial College, London, UK and colleagues in the

CHARISMA (Chugai Humanized Anti-Human Recombinant Interleukin-6 Monoclonal

Antibody) Study Group investigated the safety and efficacy of tocilizumab

alone and in combination with methotrexate in 359 RA patients showing an

inadequate response to methotrexate.

Significantly more patients treated with only tocilizumab (61%-63%) than

treated with only methotrexate (41%) achieved an ACR20 response by week 16,

the researchers report. Among patients receiving the highest dose of

tocilizumab along with methotrexate, 74% achieved ACR20 responses.

Tocilizumab 8 mg/kg plus methotrexate was significantly better than placebo

in providing ACR50 and ACR70 responses, the results indicate.

Remission rates were highest among patients assigned to tocilizumab 8 mg/kg

plus methotrexate (34%), intermediate among those receiving tocilizumab 8

mg/kg monotherapy (17%), and lowest among patients receiving methotrexate

monotherapy (8%), the researchers report.

Tocilizumab was well tolerated, the report indicates, although tocilizumab

therapy was associated with transient increases in liver function tests,

bilirubin values, and lipid levels, as well as dose-dependent reductions in

neutrophil counts.

" The results of this study indicate that targeted blockade of IL-6 is a

highly efficacious and promising means of decreasing disease activity in

patients with RA, and that tocilizumab treatment (as monotherapy or in

combination with methotrexate) is well tolerated in the majority of cases, "

Dr. Maini and colleagues conclude.

" Five global phase III trials are running in populations of varying types, "

in combination with other anti-rheumatic drugs, MacLean said. " In

addition, monotherapy is being studied and there's a joint damage prevention

study. "

Arthritis & Rheumatism 2006;54:2817-2829.

http://www.medscape.com/viewarticle/546264

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