Rheumatoid Arthritis Drug for Adults, Children 1

 
Thursday, March 20, 2008; 12:00 AM

THURSDAY, March 20, The new anti-arthritis drug tocilizumab, now being tested, appears to be effective in relieving the symptoms of rheumatoid arthritis in both adults and children, according to the results of two new studies.

Tocilizumab works by blocking the interleukin-6 receptor. Interleukin-6 is a molecule involved in promoting the painful inflammation in rheumatoid arthritis.

The new findings are published in the March 22 issue ofThe Lancet.

However, one expert isn't convinced, especially for adults, that comparing tocilizumab to a placebo -- as was done in these studies -- proves that the drug is a better option than existing medications.

"It's not good enough to know if the new medication is working better than nothing," said Dr. Tim Bongartz, a rheumatologist at the Mayo Clinic College of Medicine and author of an accompanying editorial in the journal. "To answer the question of which of four or five [drug] options available I should choose, we need to know all the potential benefits and potential risks," he said.

In one study, led by Dr. Josef Smolen, of the division of rheumatology at the Medical University of Vienna, Austria, 623 people with moderate to severe rheumatoid arthritis were randomly assigned to receive tocilizumab or a placebo. In addition, the patients continued to receive the standard arthritis drug methotrexate.

The researchers found that after 24 weeks, 59 percent of the patients taking the highest dose of tocilizumab had at least a 20 percent improvement in symptoms of rheumatoid arthritis, compared with 26 percent of the patients receiving a placebo.

The most common serious side effects were severe infections among six patients receiving the highest dose of tocilizumab, according to the report.

The study was funded by drug makers F. Hoffman-La Roche and Chugai Pharmaceuticals, which together are developing tocilizumab.

"These data provide evidence that inhibition of interleukin-6-mediated pro-inflammatory effects significantly and rapidly improves the signs and symptoms of rheumatoid arthritis," Smolen's team wrote. "Thus, tocilizumab could be an effective agent for the treatment of patients with moderate to severe rheumatoid arthritis."

But Bongatrz countered that "it's no surprise that tocilizumab works better than nothing [placebo]. The question is, does it work better than the alternatives we already have available?"

In addition, there are potential problems with tocilizumab, Bongartz said. For one, this study didn't show whether the drug slows the progression of the disease. Also, the drug significantly increased patients' cholesterol levels, which Bongartz finds troubling.

Steven Reinberg

Source HealthDay