Tocilizumab trumps etanercept at suppressing RA joint erosion

Treatment with tocilizumab leads to better suppression of joint erosion progression as compared to etanercept in patients with rheumatoid arthritis (RA), reports a recent study.

Researchers enrolled 187 patients, of whom 106 (mean age 62.8 years, 81 women) were treated with tocilizumab and 81 (mean age 51.3 years, 65 women) with etanercept. Joint destruction was measured using x-rays. Patients were also evaluated using the clinical disease activity index (CDAI) and modified health assessment questionnaire (mHAQ).

After propensity score matching, 38 patients remained in each group. The number of patients with no Sharp erosin score was significantly higher in the tocilizumab vs etanercept arm (86.8 percent vs 63.2 percent; p=0.032). The same was true for a Sharp score ≤0.5.

The proportion of patients with Sharp scores lower than the smallest detectable change was also significantly higher in the tocilizumab group (p=0.032).

Pearson’s correlation analysis revealed that CDAI (coefficient, 0.37; p<0.001) and mHAQ (coefficient, 0.30; p=0.008) scores were significantly and directly correlated with yearly progression of erosion. Multivariate analysis confirmed this interaction for higher CDAI at baseline, which was associated with a 5-percent increase in the likelihood of greater bone erosion (odds ratio, 1.05, 95 percent confidence interval, 1.003–1.099; p=0.037).

“In the present study, we demonstrated that the radiographic progression of joint erosion with tocilizumab treatment was significantly lower than that with etanercept treatment for RA,” the researchers said. “Multivariate analysis demonstrated that radiographic progression of joint erosion was associated with the baseline CDAI.”