THURSDAY, July 27, 2017 (HealthDay News) — Tocilizumab (Actemra) combined with a 26-week prednisone taper is superior to either 26-week or 52-week prednisone tapering plus placebo with regard to sustained glucocorticoid-free remission in patients with giant-cell arteritis, according to a study published in the July 26 issue of the New England Journal of Medicine.
Researchers randomized 251 patients, in a 2:1:1:1 ratio, to receive subcutaneous tocilizumab weekly or every other week, combined with a 26-week prednisone taper, or placebo combined with a prednisone taper over a period of either 26 weeks or 52 weeks.
The team noted sustained remission at week 52 in 56 percent of the patients treated with tocilizumab weekly, 53 percent of those treated with tocilizumab every other week, 14 percent of those in the placebo group with 26-week prednisone taper, and 18 percent of those in the placebo group with 52-week prednisone taper. Serious adverse events were noted in 15 percent of patients receiving tocilizumab weekly, 14 percent of patients receiving tocilizumab every other week, 22 percent of patients in the placebo group with 26-week taper, and 25 percent of patients in the placebo group with 52-week taper.
“This trial is the first to demonstrate beyond any doubt that an alternative to chronic, unending steroid treatment exists,” lead author John Stone, M.D., M.P.H., a rheumatologist at Massachusetts General Hospital in Boston, said in a hospital news release. “One of the most surprising findings was just how poorly the traditional, steroid-only regimens worked. These results are likely to have an immediate, sustained impact on the lives of hundreds of thousands of patients across the world.”
The study was funded by F. Hoffmann-La Roche; Genentech, a member of the Roche group, manufactures tocilizumab.
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