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Patients with RA refractory to anti-TNF-α may respond to tocilizumab
Tocilizumab (Actemra), an interleukin-6 receptor inhibitor, may be effective in the treatment of patients with rheumatoid arthritis who have an inadequate response to anti-tumor necrosis factor-α therapy, according to research presented here at the 39th annual meeting of the American College of Clinical Pharmacology, Baltimore.
Key Points
Tocilizumab (Actemra) (TCZ), an interleukin-6 receptor inhibitor, may be effective in the treatment of patients with rheumatoid arthritis (RA) who have an inadequate response to anti-tumor necrosis factor-α (anti-TNF-α) therapy, according to research presented here at the 39th annual meeting of the American College of Clinical Pharmacology, Baltimore.
In this analysis of the Research of Actemra Determining effIcacy after Anti-TNF failurEs (RADIATE) trial, a randomized, double-blind, phase 3 study, 489 patients with RA whose disease had failed treatment with 1 or more anti-TNF-α agent received either TCZ (4 or 8 mg/kg) or placebo every 4 weeks, plus methotrexate (10 to 25 mg/wk).
Primary efficacy outcome was American College of Rheumatology (ACR) 20 response at week 24. These responses were significantly better in patients receiving TCZ 8 mg and TCZ 4 mg compared with the control group (50%, 30.4%, and 10.1%, respectively; P≤.0001).
Remission based on mean disease activity scores based on 28 joints (DAS8) was also significantly greater in the TCZ 8-mg group compared with control (score <2.6; 30% vs 2%, respectively; P≤.0001).
The incidence of adverse events was similar in all 3 treatment groups (84% in TCZ 8 mg, 87% in TCZ 4 mg, and 81% in the control group). Serious adverse events were also similar in the 3 groups (6%, 7%, and 11%, respectively), as was the incidence of serious infection (5%, 2%, and 3%, respectively).
"Treatment with both doses of TCZ was significantly superior to control in achieving ACR20 response in patients with RA who had a previously inadequate response to anti-TNF-α therapy. Response to both doses of TCZ was rapid and was sustained throughout the study period. Improvement in ACR20 was seen as early as 2 weeks after therapy initiation," noted lead author Paul Emery, MD. Dr Emery is Arthritis Research Campaign professor of rheumatology, head of the Academic Unit of Musculoskeletal Medicine at the University of Leeds, and clinical director of rheumatology at the Leeds Teaching Hospitals Trust, UK.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
