Tocilizumab is more effective than adalimumab at reducing signs and symptoms of rheumatoid arthritis

"Approximately one third of patients with rheumatoid arthritis receive biologic monotherapy and this is the first head-to-head trial comparing an IL-6 inhibitor to an anti-TNF, two therapies with different modes of action," said Professor Cem Gabay from University Hospitals of Geneva, Switzerland. "This study clearly shows the benefits of tocilizumab over adalimumab on various measures of rheumatoid arthritis disease activity and is the first study of its kind to determine superiority between two approved RA drugs."

The international, multicenter, randomised, double-blind, 24 week study was designed to test for treatment superiority in patients with an RA diagnosis of greater than six months who were methotrexate intolerant or for whom continued treatment with methotrexate was inappropriate. Patients were randomly assigned to two arms for a total of 24 weeks: tocilizumab 8mg/kg IV every four weeks plus placebo or adalimumab 40mg subcutaneously every two weeks plus placebo. The primary endpoint of the study was mean change from baseline in DAS28 at 24 weeks.

The incidence of adverse events (AEs) was similar between groups, with 82.1% of patients having an AE in the tocilizumab arm and 82.7% in the adalimumab arm. Serious AEs and serious infections were also similar between groups (tocilizumab: 11.7%, 3.1%, adalimumab: 9.9%, 3.1%). Changes in transaminase, low-density lipoprotein (LDL) elevations, and neutrophil reductions occurred in both arms, with the proportion of patients with abnormal values higher in the tocilizumab arm. There were two deaths reported in the tocilizumab arm; one from sudden death and one from illicit drug overdose.

More information: Abstract Number: LB0003

Provided by European League Against Rheumatism