Rheumatoid arthritis (RA) is is an autoimmune inflammatory disease affecting the patient systemically.
It is associated with progressive joint damage, pain, fatigue, and disability. Systemic-onset juvenile idiopathic arthritis (SOJIA) is a more specific type of childhood diabetes with an unknown cause. Both conditions are related to the activity of the cytokine compound interleukin 6, which is involved in the activation of cells in the inflammatory response.
According to two studies published in the March 22, 2008 issue of The Lancet, the arthritis drug tocilizumab is effective in both juvenile and adult rheumatoid arthritis (RA).
In the first of the two investigations, Professor Josef Smolen, Division of Rheumatology, Medical University of Vienna, Austria, and colleagues, performed a phase III trial of 623 adults with moderate to severe rheumatoid arthritis.
The patients were randomly assigned to receive tocilizumab intravenously every four weeks at one of the following doses: 8 mg/kg body weight (205 patients), 4 mg/kg (214 patients) or a placebo (204). This was paired in all groups with 10-25 mg doses each week of methotrexate, an arthritis drug that has shown to be stable before the study at these concentrations.
The primary endpoint of the study was the proportion of patients maintaining 20% improvement in symptoms of RA, according to criteria set forward by the American College of Rheumatology, also referred to as an ACR20 response.
More ACR 20 responses were recorded in tocilizumab patients than in the placebo group. That is, at 24 weeks, this was true for 59% of the patients given 8 mg/kg, 48% given 4 mg/kg, and 26% given the placebo. Patients in the 8 mg/kg were four times more likely to give an ACR20 response than the placebo, and patients in the 4 mg/kg group were more than two and a half time more likely than a placebo.
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