Key clinical point: Tocilizumab (TCZ) and methotrexate (MTX) combination therapy was generally more effective than TCZ monotherapy in preventing radiographic progression in patients with early and established rheumatoid arthritis. However, effect modifiers were more joint damage or lower disease activity score (DAS) in early RA and longer disease duration in established RA.
Major finding: Overall, TCZ monotherapy was less effective in preventing radiographic progression (relative risk; 95% confidence interval) than TCZ+MTX combination therapy in patients with early (0.96; 0.90 to –1.03) and established (0.96; 0.87 to –1.07) RA. These effects were modified by baseline joint damage ( P less than .01), DAS assessing 28 joints ( P = .04) in early RA, and disease duration ( P = .04) in established RA.
Study details: Analysis of individual patient data from randomized controlled trials comparing TCZ monotherapy and TCZ+MTX combination therapy in patients with early (n=1,089) and established (n=417) RA.
Disclosures: No study sponsor was identified. Some of the investigators reported ties with various pharmaceutical companies.
Source: Verhoeven MMA et al. Arthritis Care Res (Hoboken). 2020 Nov 30. doi: 10.1002/acr.24524.