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Sustained Response Following Discontinuation of Methotrexate in Patients with Rheumatoid Arthritis Treated with Subcutaneous Tocilizumab

Kremer JM, Rigby W, Singer NG, Birchwood C, Gill D, Reiss W, Pei J, Michalska M. - Arthritis Rheumatol 2018;70:1200–08 DOI 10.1002/art.40493

The COMP-ACT study showed patients achieving low disease activity (LDA) with tocilizumab (TCZ) plus methotrexate (MTX) can discontinue MTX, while maintaining disease control for up to 16 weeks.
Previous studies have shown TCZ to be efficacious as a monotherapy or in combination with MTX in patients with RA1,2. Patients frequently discontinue taking DMARDs, such as MTX, due to intolerance or adverse events.
COMP-ACT is a randomised, double-blind, 52-week study evaluating the sustained efficacy of subcutaneous TCZ monotherapy versus combination therapy, following combination therapy for 24 weeks.
The mean change in the DAS28 from discontinuation to Wk40 was similar for both treatment groups. Additionally, the proportion of patients who maintained LDA or remission at Wks40 and 52 were similar between treatment arms.
Safety outcomes in this study were comparable between the treatment groups. There was a slightly higher incidence of adverse events (AEs) in patients randomized to combination therapy
The authors concluded that, in patients achieving LDA with MTX and TCZ combination therapy, MTX can be discontinued without diminishing disease control for up to 16 weeks.
1. Burmester GR, et al. Ann Rheum Dis 2017;76:1279–84.
2. Gabay C, et al. Lancet 2013;381:1541–50.

Keywords: IL-6, Tocilizumab, Clinical, Efficacy

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Upload date: September 2018

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