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Tocilizumab Effective for Rheumatoid Arthritis

But interleukin-6 receptor inhibitor resulted in more adverse effects than placebo

FRIDAY, March 21 (HealthDay News) -- In patients with moderate to severe active rheumatoid arthritis, treatment with tocilizumab -- an interleukin-6 receptor inhibitor -- may be an effective approach, according to an article published in the March 22 issue of The Lancet.

Josef S. Smolen, M.D., of the Medical University of Vienna in Austria, and colleagues randomly assigned 623 patients to receive either intravenous tocilizumab at a dosage of 8 mg/kg, 4 mg/kg, or placebo every four weeks in combination with methotrexate at stable pre-study doses.

After 24 weeks, the researchers found that the proportion of patients with 20 percent improvement in signs and symptoms of rheumatoid arthritis was higher in patients receiving tocilizumab than in those receiving placebo (59 percent in the 8 mg/kg group and 48 percent in the 4 mg/kg group versus 26 percent in the placebo group). But they also found that the rate of adverse events was higher among patients receiving tocilizumab than among those receiving placebo (69 percent in the 8 mg/kg group and 71 percent in the 4 mg/kg group versus 63 percent in the placebo group).

"In this study, tocilizumab produced a marked improvement from baseline in all American College of Rheumatology (ACR) core set variables and significantly more patients on the drug achieved ACR20, ACR50, and ACR70 responses than did those in the placebo group," the authors write. "About a quarter of patients treated with tocilizumab 8 mg/kg -- compared with less than 1 percent on placebo -- achieved DAS28 [disease activity score 28] remission."

The study was supported by Hoffmann-La Roche, Chugai Pharmaceutical, and several co-authors disclosed financial ties to pharmaceutical companies.

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