Comparison of tocilizumab monotherapy versus methotrexate monotherapy in patients with moderate to severe rheumatoid arthritis: The AMBITION study
Graeme Jones,Anthony Sebba,Jieruo Gu,Mitchell B. Lowenstein,Armando Calvo,Juan J. Gomez-Reino,Daniel Siri,Matija Tomšič,Emma Alecock,Thasia G. Woodworth,Mark C. Genovese +10 more
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TLDR
Tocilizumab monotherapy is better than methotrexate monotherapy, with rapid improvement in RA signs and symptoms, and a favourable benefit–risk, in patients for whom treatment with methotRexate or biological agents has not previously failed.Abstract:
Background: The anti-interleukin (IL) 6 receptor antibody tocilizumab inhibits signalling of IL6, a key cytokine in rheumatoid arthritis (RA) pathogenesis. Objective: To evaluate through the AMBITION study the efficacy and safety of tocilizumab monotherapy versus methotrexate in patients with active RA for whom previous treatment with methotrexate/biological agents had not failed. Methods: This 24-week, double-blind, double-dummy, parallel-group study, randomised 673 patients to either tocilizumab 8 mg/kg every 4 weeks, or methotrexate, starting at 7.5 mg/week and titrated to 20 mg/week within 8 weeks, or placebo for 8 weeks followed by tocilizumab 8 mg/kg. The primary end point was the proportion of patients achieving American College of Rheumatology (ACR) 20 response at week 24. Results: The intention-to-treat analysis demonstrated that tocilizumab was better than methotrexate treatment with a higher ACR20 response (69.9 vs 52.5%; p 3×– Conclusion: Tocilizumab monotherapy is better than methotrexate monotherapy, with rapid improvement in RA signs and symptoms, and a favourable benefit–risk, in patients for whom treatment with methotrexate or biological agents has not previously failed. Trial registration number: NCT00109408read more
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Tocilizumab: Another medication related to osteonecrosis of the jaws? A case report and literature review
Andreas Sakkas,Sebastian Heil,Steffen Kargus,Martin Rebel,Robert A. Mischkowski,Oliver C. Thiele +5 more
TL;DR: In this paper, the authors reported a case of MRONJ in a patient treated with tocilizumab, a humanized anti-interleukin-6 receptor antibody that effectively treats moderate to severe rheumatoid arthritis in adults.
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Anti citrullinated protein antibodies and mechanism of action of common disease modifying drugs--insights in pathomechanisms of autoimmunity.
Georg Pongratz,Martin Fleck +1 more
TL;DR: The authors explain their understanding of the autoimmune process as a continuous repeat of autoantigen presentation - autoreactive effector cell activation - destruction of tissue - liberation of new autoantigens - and again autoantige presentation, which closes the vicious circle.
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Tocilizumab, a humanized anti-interleukin-6 receptor antibody, for the treatment of autoimmune disorders
Toshio Tanaka,Keisuke Hagihara,Yoshihito Shima,Masashi Narazaki,Atsushi Ogata,Atsushi Kumanogoh +5 more
TL;DR: Results of recent pilot or case studies have indicated that tocilizumab may become a novel drug for various other autoimmune disorders, including systemic lupus erythematosus, systemic sclerosis, polymyositis, and vasculitis syndrome, as well as inflammatory disorders such as adult‐onset Still's disease, Crohn's disease and polymyalgia rheumatica.
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Magnetic Resonance Imaging (MRI) Results Following Discontinuation of Methotrexate in Rheumatoid Arthritis Treated with Subcutaneous Tocilizumab: The COMP-ACT MRI Substudy.
Charles Peterfy,Joel M. Kremer,William F. C. Rigby,Nora G. Singer,Christine Birchwood,Darcy Gill,William Reiss,Jinglan Pei,Margaret Michalska +8 more
TL;DR: MRI changes were minimal in intraarticular inflammation and damage measures in patients who discontinued MTX versus those who continued TCZ + MTX, and the proportion of patients with no progression in each outcome measure was similar between groups.
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