RA patient-reported outcomes favor sarilumab over adalimumab
medwireNews: Patients with rheumatoid arthritis (RA) have reported greater improvements with sarilumab versus adalimumab in multiple outcomes, complementing its superior clinical efficacy profile already reported in the MONARCH trial.
In the phase III trial, patients with active RA who were intolerant or failed to adequately respond to methotrexate were randomly assigned to receive the anti-interleukin-6 receptor monoclonal antibody sarilumab 200 mg or adalimumab 40 mg every 2 weeks for 24 weeks.
Significant improvements in patient-reported outcomes were seen in both treatment groups. But least-squares mean changes from baseline to 24 weeks were significantly greater with sarilumab than adalimumab in patient global assessment of disease activity, physical functioning, pain, Health Assessment Questionnaire Disability Index (HAQ-DI) scores, and the physical component summary of the Short Form-36 (SF-36) questionnaire.
Significantly greater reductions in morning stiffness and improvements in work-related and productivity measures were also reported with sarilumab compared with adalimumab.
Chieh-I Chen (Regeneron Pharmaceuticals, Tarrytown, New York, USA) and colleagues also note more favorable outcomes with sarilumab on the Rheumatoid Arthritis Impact of Disease, which looks at pain, functional disability, fatigue, sleep, physical/emotional wellbeing, and coping, demonstrating the agent’s “broad benefits […] in reducing the impact of RA on patients’ lives.”
And they highlight a key finding that a greater proportion of patients taking sarilumab achieved normative values for the US general population across HAQ-DI, fatigue, and SF-36 measures, ranging from 10.3% to 30.4%, compared with 7.0% to 28.1% of those taking adalimumab. This was up from baseline rates of 1.1% to 15.1% across the two groups.
“These data indicate that attainment of normative values is now a reasonable goal for RA therapy,” Chen and team report in Arthritis Research & Therapy.
They conclude: “Reducing the impact of RA on patients’ lives is an important treatment objective, and these data indicate that sarilumab monotherapy may result in better patient-reported benefits than monotherapy with a widely used [biologic] DMARD, adalimumab.”
By Lucy Piper
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