Can Tocilizumab Treat RA After Non-TNFi Failure?

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For patients with RA and a first non-TNFi failure, treatment with tocilizumab seems more efficacious than abatacept or rituximab.
For patients with RA and a first non-TNFi failure, treatment with tocilizumab seems more efficacious than abatacept or rituximab.

HealthDay News -- For patients with rheumatoid arthritis (RA) and a first non-tumor necrosis factor inhibitor (TNFi) failure, treatment with tocilizumab seems more efficacious than abatacept or rituximab, according to a study published in the International Journal of Rheumatic Diseases.

Tristan Pascart, MD, from Lille University in Lomme, France, and colleagues conducted a retrospective, multicenter study involving patients treated for RA with abatacept, rituximab, or tocilizumab after a non-TNFi failure. Data were collected for 100 patients who started a second non-TNFi between 2006 and 2013 (15 treated with rituximab, 36 with tocilizumab, and 49 with abatacept).

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The researchers found that the change in Disease Activity Index of 28 joints-erythrocyte sedimentation rate (DAS28-ESR) differed significantly between the groups (P = 0.001). The decrease in DAS28-ESR was higher for patients treated with tocilizumab versus abatacept (median, 36 versus 0%; P = 0.002). A similar difference was seen for tocilizumab and rituximab, although the difference was not significant (median decrease, 36 versus 0%; P = 0.07). The results were similar for 12-month change in DAS28-C-reactive protein.

"This study suggests a better efficacy of tocilizumab compared with abatacept and rituximab in situations of non-TNFi failure," the authors wrote.

Several authors disclosed financial ties to the pharmaceutical and medical technology industries.

Reference

Pascart T, Philippe P, Drumez E, Deprez X, Cortet B, Duhamel A, et al. Comparative efficacy of tocilizumab, abatacept and rituximab after non-TNF inhibitor failure: results from a multicentre study. Int J Rheum Dis. 2016. doi:10.1111/1756-185X.12845.

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