Starting Therapy with Tocilizumab Improves Early Remission Rates in Rheumatoid Arthritis

Patients with early rheumatoid arthritis (RA) usually are treated initially with synthetic disease-modifying antirheumatic drugs (DMARDs), preferably methotrexate. In this industry-sponsored study, researchers examined early use of the biologic drug tocilizumab (Actemra; an interleukin-6 receptor antagonist) in 317 DMARD-naive patients with early RA. Patients were randomized to tocilizumab plus methotrexate, tocilizumab alone, or methotrexate alone (with matching placebos). If sustained remission (≥24 weeks) was not achieved on initial regimens at the maximum methotrexate dose — and after addition of a second synthetic DMARD — monotherapy patients were switched to combination therapy, and combination-therapy patients were switched to standa…