Tocilizumab is more effective in suppressing the radiographic progression of joint erosion than etanercept, and the progression is associated with baseline clinical disease activity index (CDAI), according to an advanced study published by Shinya et al. in Scientific Reports.
The retrospective study compared the radiographic progression of structural joint damage in patients treated with tocilizumab (n=106) and etanercept (n=81) using the Sharp erosion score, the cumulative distribution of modified total Sharp score (mTSS), and Sharp joint space narrow score variation. Multivariate analysis showed significant association between radiographic delta erosion and baseline CDAI (P=0.037). The researchers also noted significantly higher proportion of subjects treated with tocilizumab had no Sharp erosion score progression as opposed to etanercept treatment (P = 0.032).
In concurrence with the present study, Xavier and co-workers (2018), reported that tocilizumab-based treatment helped in inhibiting the progression of erosions in DMARD-naïve early RA patients when compared to step-up methotrexate strategy. The study has noted less progression of erosions in the feet after 104 weeks upon treatment with tocilizumab (P ≤0.046); however, the finding was not significant for the hands (P≥ 0.11).
Since radiographic damage is one of the most important outcomes of RA, the present study may help in developing new target-based therapies for the effective reduction of the progression of joint destruction.
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References:
- Hayashi S, Matsubara T, Maeda T, Fukuda K, Funahashi K, Hashimoto M, et al. Comparison of the inhibitory effect of tocilizumab and etanercept on the progression of joint erosion in rheumatoid arthritis treatment. Sci Rep. 2022 Oct 20;12(1):17524.
- Teitsma XM, Jacobs JWG, Welsing PMJ, Pethö-Schramm A, Borm MEA, van Laar JM, et al. Radiographic joint damage in early rheumatoid arthritis patients: comparing tocilizumab- and methotrexate-based treat-to-target strategies. Rheumatology. 2018 Feb 1;57(2):309–17.