Treatment with Actemra (tocilizumab) is linked to favorable outcomes, namely disease inactivation and remission, in patients with systemic juvenile idiopathic arthritis, according to an analysis of a German autoinflammatory disease registry.
The study, “IL-6 blockade in systemic juvenile idiopathic arthritis – achievement of inactive disease and remission (data from the German AID-registry),” was published in the journal Pediatric Rheumatology.
Systemic juvenile idiopathic arthritis (SJIA) is associated with the activation of specific immune cells and the release of signaling molecules called interleukins that drive inflammation — the proinflamamrory interleukins — such as interleukin 6 (IL-6).
Actemra (available as RoActemra in Europe), is an IL-6 inhibitor developed by Genentech. It is the first biological drug approved in Europe as a therapy for children ages 2 and older with active SJIA. Actemra can be administered alone or combined with methotrexate, a disease-modifying anti-rheumatic drug.
Now, researchers present the first follow-up of a group of 46 children diagnosed with SJIA enrolled in an online German registry for autoinflammatory diseases (AID) who received treatment with Actemra.
The 46 children analyzed, with a median age of 11, developed the first symptoms on average at the age of 4. Treatment with Actemra began at the age of 9, on average, and lasted for a median of 14.9 months (a little more than 1 year).
The team found that Actemra was linked to favorable outcomes — 39.1% of the patients achieved an inactive disease state and 30.4% achieved remission.
A total of 24 children underwent long-term treatment with Actemra for a median of 23 months. Of these, 54.2% achieved remission and 20.8% achieved inactive disease.
Patients who responded more rapidly to Actemra treatment showed long-term disease inactivity.
Those diagnosed with polycyclic SJIA (alternating active and inactive disease) showed the highest clinical response rate, compared to monocyclic (active disease for less than 24 months) or polyarticular disease (inflammation in five or more joints).
Regarding safety, 14 adverse events were reported in 24% of the patients (including infections and low levels of white blood cells), and two serious adverse events (Hodgkin’s lymphoma and one gut perforation).
Overall, these results support Actemra’s effectiveness in SJIA patients. According to the research team, the drug “appears to be effective in most patients. In our real-life clinical setting, we observed a clinical response rate of 35% after 12 weeks, a remission on medication in 54%, and inactive disease in 21% after 12 months.”
“It should be noted, however, that patients often require additional treatment. Fine-tuning of dosage and co-medication will need to be addressed by future long-term studies on larger patient cohorts,” the team added.