In a study that compared Actemra® (tocilizumab) with Humira® (adalimumab) for the treatment of rheumatoid arthritis (RA), Actemra was more effective at reducing RA symptoms. These results were presented at the 2012 annual meeting of the European League Against Rheumatism.
Rheumatoid arthritis affects an estimated 1.3 million adults in the United States. The good news is that important advances have been made in the management of RA: use of more effective drugs earlier in the course of RA reduces symptoms and joint damage, and allows some patients to achieve a remission (little or no active disease).
Treatment of RA often begins with methotrexate or another disease-modifying antirheumatic drug (DMARD). If this initial treatment does not adequately control the RA, patients may move on to treatment with a newer, biologic DMARD such as Humira. Humira acts by inhibiting TNF, a protein that plays a role in inflammation.
Actemra is also a biologic DMARD, but has a different mechanism of action than Humira. Actemra blocks the action of a protein known as IL-6. IL-6 plays a role in inflammation and can contribute to the signs and symptoms of RA by prompting white blood cells to attack certain tissues in the body. Actemra may be used after treatment with a TNF inhibitor such as Humira has failed.
To directly compare Actemra and Humira, researchers conducted a study among 325 RA patients who could not continue treatment with methotrexate. Patients were treated with either Actemra alone (8 mg/kg IV every 4 weeks) or Humira alone (40 mg subcutaneously every 2 weeks).
- Based on the DAS28 (a commonly used measure of RA activity), patients treated with Actemra had a greater reduction in disease activity than patients treated with Humira.
- Based on ACR20 criteria, 65% of patients treated with Actemra had at least a 20% reduction in symptoms, compared with 49% of patients treated with Humira.
For patients who receive treatment with only a single RA drug and cannot take methotrexate, these results suggest that Actemra may be more effective than Humira.
Reference: Gabay C, Emery P, van Vollenhoven R et al. Tocilizumab (TCZ) monotherapy is superior to adalimumab (ADA) monotherapy in reducing disease activity in patients with rheumatoid arthritis (RA): 24-week data from the phase 4 ADACTA trial. Paper presented at: 2012 Annual Meeting of the European League Against Rheumatism; June 1-5, 2012; Chicago, IL. Abstract LBA0003.