PHILADELPHIA – Investigators are reporting that tolicizumab is an effective, long-term treatment option in multiple subgroups of rheumatoid arthritis (RA) patients.

These include patients who have an inadequate response to disease-modifying anti-rheumatic drugs (DMARD-IR), patients who have an inadequate response to anti-TNF inhibitors (TNF-IR), and patients who have not failed methotrexate.

The new results were announced at the 2009 American College of Rheumatology (ACR) Annual Scientific Meeting.

Joseph S. Smolen, MD, chairman of the rheumatology department at the Medical University of Vienna in Vienna, Austria, and colleagues presented 3.5-year data in 3,986 patients.

Tocilizumab is a humanized monoclonal antibody to the interleukin-6 (IL-6) receptor that inhibits IL-6 binding to its receptor, thus preventing IL-6 mediated proinflammatory activity.

The efficacy and safety of tocilizumab in RA patients for up to one year has been demonstrated in phase 3 trials and for up to 2.5 years has been demonstrated in long-term extension studies.

In the updated analysis, the efficacy of tocilizumab in DMARD-IR patients was evidenced by increased numbers of patients who achieved an American College of rheumatology (ACR) ACR50 and ACR70 up to weeks 72 and 96, respectively, and who achieved maintenance of ACR70 for 24 consecutive weeks, low disease activity score (LDAS), and disease activity score including a 28-joint count (DAS28) remission up to week 72.

Thereafter, proportions increased further or were maintained with continued tocilizumab up to week 180.

In anti-TNF-IR and monotherapy patients, the percentages achieving these endpoints increased or were maintained with continued tocilizumab treatment. At 96 weeks, proportions in the DMARD-IR, anti-TNF-IR, and monotherapy groups with health assessment questionnaire (HAQ)=0 were 15%, 8%, and 23%, respectively; the proportions with ≤1 SJC were 46%, 34%, and 55%, respectively; and the proportions with ≤1 total joint count (TJC) were 37%, 23%, and 35%, respectively.

Overall, the analysis shows that during long-term treatment with tocilizumab, the number of patients responding and the magnitude of patient response increased beyond 24 weeks, Dr. Smolen said.

Jill Stein is a Paris-based freelance medical writer.
Jillstein03(at)qmail.com