The Year in Rheumatology: 2013
The Year in Rheumatology: 2013
Two welcome comparative effectiveness trials were reported on this year. The first was a head-to-head phase 3b randomized noninferiority trial comparing subcutaneous abatacept (Orencia®) and subcutaneous adalimumab (Humira®). The agents were found to be equally effective in patients with RA; however, more injection-site reactions were seen with adalimumab. As Medscape Medical News reported, "Adding either treatment to background methotrexate (MTX) produced similar American College of Rheumatology 20 improvement response (ACR20) rates and similar rates of radiographic nonprogression."
The second trial, ADACTA, compared intravenous tocilizumab monotherapy with adalimumab monotherapy in patients with severe RA of 6 months' duration or more, and who were intolerant to methotrexate or were inappropriate for continued methotrexate treatment. Results demonstrated that tocilizumab was superior to adalimumab in reducing RA symptoms in this patient population. The primary endpoint was change in DAS28 from baseline to week 24. Higher rates of low-density lipoprotein cholesterol and aminotransferase increases, and reduced platelet and neutrophil counts, were seen in the tocilizumab group.
Despite the debates swirling around Washington regarding the Affordable Care Act, the push for comparative effectiveness studies such as these that arise from the Act allow a better appreciation of the relative effectiveness and potential interchangeability of these drugs in practice.
Comparative Effectiveness
Two welcome comparative effectiveness trials were reported on this year. The first was a head-to-head phase 3b randomized noninferiority trial comparing subcutaneous abatacept (Orencia®) and subcutaneous adalimumab (Humira®). The agents were found to be equally effective in patients with RA; however, more injection-site reactions were seen with adalimumab. As Medscape Medical News reported, "Adding either treatment to background methotrexate (MTX) produced similar American College of Rheumatology 20 improvement response (ACR20) rates and similar rates of radiographic nonprogression."
The second trial, ADACTA, compared intravenous tocilizumab monotherapy with adalimumab monotherapy in patients with severe RA of 6 months' duration or more, and who were intolerant to methotrexate or were inappropriate for continued methotrexate treatment. Results demonstrated that tocilizumab was superior to adalimumab in reducing RA symptoms in this patient population. The primary endpoint was change in DAS28 from baseline to week 24. Higher rates of low-density lipoprotein cholesterol and aminotransferase increases, and reduced platelet and neutrophil counts, were seen in the tocilizumab group.
Despite the debates swirling around Washington regarding the Affordable Care Act, the push for comparative effectiveness studies such as these that arise from the Act allow a better appreciation of the relative effectiveness and potential interchangeability of these drugs in practice.
