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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Adverse effects of biologics: a network meta‐analysis and Cochrane overview
Jasvinder A. Singh,George A. Wells,Robin Christensen,Elizabeth Tanjong Ghogomu,Lara J Maxwell,John K MacDonald,Graziella Filippini,Nicole Skoetz,Damian K Francis,Luciane Cruz Lopes,Gordon Guyatt,Jochen Schmitt,Loredana La Mantia,Tobias Weberschock,Juliana F. Roos,Hendrik Siebert,Sarah. Hershan,Chris Cameron,Michael P. Lunn,Peter Tugwell,Peter Tugwell,Rachelle Buchbinder +21 more
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Tocilizumab monotherapy versus adalimumab monotherapy for treatment of rheumatoid arthritis (ADACTA): a randomised, double-blind, controlled phase 4 trial
Cem Gabay,Paul Emery,Ronald F van Vollenhoven,Ara Dikranian,Rieke Alten,Karel Pavelka,Micki Klearman,David Musselman,Sunil Agarwal,Jennifer Green,Arthur Kavanaugh +10 more
TL;DR: Tocilizumab monotherapy was superior to adalimumabmonotherapy for reduction of signs and symptoms of rheumatoid arthritis in patients for whom methotrexate was deemed inappropriate.
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Tofacitinib versus Methotrexate in Rheumatoid Arthritis
E.B. Lee,Roy Fleischmann,Stephen Hall,Bethanie Wilkinson,John D. Bradley,David Gruben,Tamas Koncz,Sriram Krishnaswami,Gene V. Wallenstein,Chuanbo Zang,Samuel H. Zwillich,Ronald F van Vollenhoven +11 more
TL;DR: Tofacitinib monotherapy was superior to methotrexate in reducing signs and symptoms of rheumatoid arthritis and inhibiting the progression of structural joint damage.
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Baricitinib versus Placebo or Adalimumab in Rheumatoid Arthritis
Peter C. Taylor,Edward C. Keystone,Désirée van der Heijde,Michael E. Weinblatt,Liliana del Carmen Morales,Jaime Reyes Gonzaga,Sergey Yakushin,T. Ishii,K. Emoto,Scott Beattie,Vipin Arora,Carol L. Gaich,Terence Rooney,Douglas E Schlichting,William L. Macias,Stephanie de Bono,Yoshiya Tanaka +16 more
TL;DR: In patients with rheumatoid arthritis who had had an inadequate response to methotrexate, baricitinib was associated with significant clinical improvements as compared with placebo and adalimumab.
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Targeting Interleukin-6 Signaling in Clinic
TL;DR: The current state of IL-6-targeting approaches in the clinic is reviewed and how to apply the growing understanding of the immunobiology ofIL-6 to clinical decisions is discussed.
References
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TL;DR: Subcutaneous [corrected] etanercept acted more rapidly to decrease symptoms and slow joint damage in patients with early active rheumatoid arthritis.
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