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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Rheumatoid factor as predictor of response to abatacept, rituximab and tocilizumab in rheumatoid arthritis: Systematic review and meta-analysis.
TL;DR: In RA, RF positivity predicts better response to RTX and TCZ but not to ABT, and no asymmetries in the funnel plots or significant variables were found in the meta-regression.
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Adverse reactions to biologic agents and their medical management
TL;DR: The AEs associated with biologic therapy most relevant to rheumatic and immunological diseases are reviewed, and their underlying pathogenesis is discussed.
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Effects of tofacitinib and other DMARDs on lipid profiles in rheumatoid arthritis: implications for the rheumatologist.
Christina Charles-Schoeman,Miguel A. González-Gay,Irina Kaplan,M. Boy,Jamie Geier,Zhen Luo,Andrea Zuckerman,R. Riese +7 more
TL;DR: Changes in both traditional lipoprotein concentrations and non-traditionallipoprotein assessments in multiple studies of treatment with disease-modifying antirheumatic drugs (DMARDs), including non-biologic and biologic DMARDs and tofacitinib are reviewed.
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Comparative effects of biologics on cardiovascular risk among older patients with rheumatoid arthritis
Jie Zhang,Fenglong Xie,Huifeng Yun,Lang Chen,Paul Muntner,Emily B. Levitan,Monika M. Safford,Shia T. Kent,Mark T. Osterman,James D. Lewis,Kenneth G. Saag,Jasvinder A. Singh,Jeffrey R. Curtis +12 more
TL;DR: Findings from this observational study of patients with RA suggested that anti-TNF biologics may be associated with higher AMI risk compared with abatacept.
Journal ArticleDOI
Comparison of adding tocilizumab to methotrexate with switching to tocilizumab in patients with rheumatoid arthritis with inadequate response to methotrexate: 52-week results from a prospective, randomised, controlled study (SURPRISE study).
Yuko Kaneko,Tatsuya Atsumi,Yoshiya Tanaka,Masayuki Inoo,Hitomi Kobayashi-Haraoka,Koichi Amano,Masayuki Miyata,Yohko Murakawa,Hidekata Yasuoka,Shintaro Hirata,Hayato Nagasawa,Eiichi Tanaka,Nobuyuki Miyasaka,Hisashi Yamanaka,Kazuhiko Yamamoto,Tsutomu Takeuchi +15 more
TL;DR: In RA patients with inadequate response to methotrexate, tocilizumab added to metotrexate more rapidly suppressed inflammation than tocilIZumab switched from methot Rexate, leading to superior clinical efficacy and prevention of joint destruction.
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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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