medwireNews: The interleukin (IL-6) inhibitor tocilizumab does not improve pain or function in patients with hand osteoarthritis (OA) relative to placebo, suggests research reported in the Annals of the Rheumatic Diseases.
“These findings do not support a role for an IL-6 signaling pathway in OA-related hand pain,” say Pascal Richette (Hôpital Lariboisière, Paris, France) and team. Nevertheless, they believe that “[l]ong-term studies to investigate the benefit of IL-6 blockade on joint structure are warranted.”
Their study involved 91 patients with hand OA who were aged an average of 64.4 years and most (82%) of whom were women.
The 45 patients who were randomly assigned to receive two intravenous infusions of tocilizumab 8 mg/kg 4 weeks apart reported similar VAS pain at week 6 (2 weeks after second dose) to that reported by the 46 patients who were given placebo. The respective mean reductions in VAS scores between baseline and week 6 were 7.9 and 9.9 points.
Among the 88% and 84% of patients in the tocilizumab and placebo arm, respectively, who received all assigned treatments and attended all required visits to any of the 11 centers involved in the study, the mean reduction in VAS pain at week 6 was also similar, at 8.3 and 9.7 points, respectively.
The two treatment groups were also comparable with respect to changes between baseline and week 6 for other secondary outcomes, namely stiffness, spontaneous painful joints, painful joints upon pressure, swollen joints, patient global assessment, physician global assessment, functional index for hand osteoarthritis, and Cochin Hand Functional Scale.
The lack of a significant difference between treatment arms was consistent across all timepoints, the researchers report.
In subgroup analyses, patients with swollen joints or self-reported knee OA also did not derive any significant alleviation of pain or improvement in function with tocilizumab versus placebo.
Adverse events (AEs) were reported among more patients given tocilizumab than placebo, at rates of 69.0% and 53.7%, respectively, with three tocilizumab-treated patients having a serious AE, comprising one case each of neutropenia, fracture, and a suicide attempt.
Infections were the most common non-serious AE, experienced by 28.6% and 14.6% of patients who received tocilizumab and placebo, respectively, which in addition to neutropenia led to three patients discontinuing treatment after one dose of tocilizumab.
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