Therapy Reduces Disease Activity in Patients With Polymyalgia Rheumatica
Tocilizumab, a monoclonal antibody that targets the interleukin-6 receptor, was shown to reduce disease activity in patients with polymyalgia rheumatica (PMR) in comparison to placebo.
Study findings published in JAMA demonstrate the long-term efficacy and safety of tocilizumab at reducing disease activity in patients with glucocorticoid-dependent-PMR.
While tocilizumab has been approved for the treatment of rheumatoid arthritis in many countries, comprehensive evidence for its efficacy in PMR is still lacking.
Data was collected through a double-blind parallel-group, placebo-controlled randomized clinical trial of 101 hospital patients in France with active PMR. Patients were randomized to receive tocilizumab or placebo every 4 weeks for 16 weeks in combination with stable doses of prednisone daily. Data was collected from February 2017 to October 2019 with final follow up in November 2020.
Primary efficacy end point was defined as C-reactive protein level ≤10 in combination “either prednisone dose ≤5 mg per day or a decrease in prednisone dose ≥10 mg from baseline at week 24.”
Disease activity scores after 16 weeks were significantly lower for patients receiving tocilizumab compared with patients in the placebo group.
“The primary end point was achieved in 67.3% of patients in the tocilizumab group and 31.4% of patients in the placebo group (adjusted difference, 36.0% [95% CI, 19.4%-52.6%]; adjusted relative risk, 2.3 [95% CI, 1.5-3.6]; P < .001,” stated researchers.
The most notable negative side effects were infections, experienced by about 45% of patients in the tocilizumab group and almost 40% of patients in the placebo group. Overall, treatment with tocilizumab was demonstrated to improve pain, function, and disease activity faster and more effectively than glucocorticoid treatment alone.
“The use of tocilizumab in addition to glucocorticoids is a promising treatment strategy to achieve remission in patients with active PMR,” the researchers concluded. “Further research is needed to confirm efficacy and to determine the balance of potential benefits and harms.”
Reference:
Devauchelle-Pensec V, Carvajal-Alegria G, Dernis E, et al. Effect of tocilizumab on disease activity in patients with active polymyalgia rheumatica receiving glucocorticoid therapy: a randomized clinical trial. JAMA. 2022;328(11):1053-1062. doi:10.1001/jama.2022.15459
