Therapy with Actemra (tocilizumab) yields high survival rates in patients with hard-to-treat polyarticular juvenile idiopathic arthritis (pJIA), and enables many patients to reach low disease activity, a real-world study in Finland reports.
The study, “Efficacy and safety of tocilizumab in a real-life observational cohort of patients with polyarticular juvenile idiopathic arthritis,” was published in the journal Rheumatology.
Polyarticular juvenile idiopathic arthritis (pJIA) develops in children younger than 16 and is characterized by inflammation in five or more joints. The disease usually manifests in finger and hand joints, but can also occur in weight-bearing joints such as the knees, and joints surrounding the jawbone.
Children with pJIA tend to have more treatment-resistant disease than those with fewer joints affected, and longer periods of active disease.
The current recommendations suggest the use of TNF inhibitors — adalimumab (brand names Humira and Cyltezo, among others), etanercept (sold as Enbrel, among others), and golimumab (Simponi; approved for pJIA in the European Union but not in the United States) — as a first choice for pJIA patients when synthetic (chemical) disease-modifying antirheumatic drugs (DMARDs) have failed.
Actemra (marketed by Genentech, a Roche subsidiary) is another biological agent approved for pJIA, which acts through a different mechanism than TNF inhibitors. It blocks an inflammatory protein called IL-6.
Actemra is approved for the treatment of children age 2 and older and can be used alone or in combination with methotrexate, an immunosuppressant conventionally used for arthritis. However, in the EU, the medicine is sold as RoActemra (marketed by Roche) and is restricted to pJIA patients in whom prior treatment with methotrexate has not worked well.
Since Actemra’s approval, there is limited information about how well it works for pJIA patients in a real-world setting.
To fill this gap in knowledge, researchers conducted a nationwide observational study in Finland to detect the patterns of usage, efficacy, and safety of Actemra in pJIA patients during routine clinical practice.
“In conclusion, our study showed that survival of [Actemra] was good and a large proportion of the hard-to-treat pJIA patients reached [low disease activity] at 12 months of treatment. The rate of LDA continued to increase among those remaining on [Actemra] throughout 24 months,” the researchers said.