Patient-Reported Outcomes in Newly Diagnosed Early Rheumatoid Arthritis Patients Treated to Target with a Tocilizumab- or Methotrexate-based Strategy

Rheumatology (Oxford) 2017 Dec 1;56(12):2179-2189 doi: 10.1093/rheumatology/kex319

Patient-reported outcomes (PROs) vastly improved in the first 24 weeks post-initiation of tocilizumab (TCZ) therapies compared to methotrexate (MTX) monotherapy in the U-Act-Early trial.U-Act-Early was a two-year, treat-to-target study that compared the safety and efficacy of TCZ and MTX treatment strategies in DMARD-naïve patients with early RA. Sustained remission was classed as more effective in patients given TCZ monotherapy or combination therapy with MTX compared to MTX alone. TCZ therapies were also found to have similar safety profiles to MTX alone¹. The present study reports the PROs of newly diagnosed patients with early RA enrolled in U-Act-Early. PRO endpoints were: FACIT-Fatigue, SF-36 Physical and Mental Component Scores, EuroQol-5 Domains and Visual Analog Scores. Patients from all therapy groups reported improvements in fatigue throughout the study. Improvements in the SF-36 physical component score were also noted throughout the study, with more significant improvements found in TCZ patients than MTX monotherapy patients. Significantly higher EuroQol-5 Domain scores were found in combination patients compared to MTX monotherapy patients, with no difference between both monotherapy groups. Improvements were found predominantly in the first 24 weeks of treatment, which could be crucial for patients when resuming work-related activities. To conclude, the authors suggested that TCZ could be a valuable first-line therapy for patients with newly diagnosed RA. ¹Bijlsma JW, et al. Early rheumatoid arthritis treated with tocilizumab, methotrexate, or their combination (U-Act-Early): a multicentre, randomised, double-blind, double-dummy, strategy trial.Lancet 2016; 388:343-55.