Rheumatoid arthritis: people on intravenous tocilizumab may be able to safely switch to subcutaneous version
People with rheumatoid arthritis who are being treated with intravenous tocilizumab may be able to switch to the subcutaneous version without it having a negative impact on the effectiveness of their treatment, according to research in Arthritis Care & Research.
Study participants were people who had completed 24 weeks treatment with the subcutaneous version of tocilizumab at 162mg every two weeks or the intravenous form at 8mg/kg every four weeks as a monotherapy. They took part an 84-week open-label extension period.
Everyone was given the subcutaneous formulation at 162mg every two weeks as a monotherapy, with the effects of switching evaluated at week 36. A total of 319 people were given one or more subcutaneous doses during the open-label extension period; 160 people switched from the intravenous version. Clinical remission rates were 62.5% for the switching group and 50% of those on the subcutaneous version alone at week 24, and at week 36 were maintained at 62.5% and 57%, respectively.
In the switching group, 9% of people who had achieved remission at week 24 did not maintain remission at week 36. Those who weighed 70kg or more were at a higher risk of lower efficacy.
“Efficacy is adequately maintained in most patients switching from intravenous tocilizumab to subcutaneous tocilizumab monotherapy,” the researchers conclude. “Patients receiving intravenous tocilizumab can switch to subcutaneous tocilizumab without serious safety concerns. Clinical efficacy may be reduced after switching in some patients with high body weight.”
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Image credit: Daniel R Blume
