Sarilumab improves patient-reported outcomes in rheumatoid arthritis patients with inadequate response/intolerance to tumour necrosis factor inhibitors.
OBJECTIVE
To evaluate effects of the anti-interleukin-6 receptor monoclonal antibody sarilumab administered with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) on patient-reported outcomes (PROs) in the TARGET trial in patients with rheumatoid arthritis (RA) with inadequate response or intolerance to tumour necrosis factor inhibitors (TNF-IR).


METHODS
546 patients (81.9% female, mean age 52.9 years) were randomised to placebo, sarilumab 150 or 200 mg subcutaneously every 2 weeks + csDMARDs. PROs included patient global assessment (PtGA); pain and morning stiffness visual analogue scales; Health Assessment Questionnaire Disability Index (HAQ-DI); Short Form-36 Health Survey (SF-36); FACIT-Fatigue (FACIT-F); Work Productivity Survey-Rheumatoid Arthritis (WPS-RA) and Rheumatoid Arthritis Impact of Disease (RAID). Changes from baseline at weeks 12 and 24 were analysed using a mixed model for repeated measures; post hoc analyses included percentages of patients reporting improvements ≥ minimum clinically important differences (MCID) and scores ≥ normative values.


RESULTS
Sarilumab + csDMARDs doses resulted in improvements from baseline at week 12 vs placebo + csDMARDs in PtGA, pain, HAQ-DI, SF-36 and FACIT-F that were maintained at week 24. Sarilumab improved morning stiffness and reduced the impact of RA on work, family, social/leisure activities participation (WPS-RA) and on patients' lives (RAID). Percentages of patients reporting improvements ≥MCID and ≥ normative scores were greater with sarilumab than placebo.


CONCLUSIONS
In patients with TNF-IR RA, 150 and 200 mg sarilumab + csDMARDs resulted in clinically meaningful patient-reported benefits on pain, fatigue, function, participation and health status at 12 and 24 weeks that exceeded placebo + csDMARDs, and were consistent with the clinical profile previously reported.


BACKGROUND
NCT01709578; Results.
Stanford University School of Medicine , Palo Alto, California , USA.
Vibeke
V
Strand
Sanofi , Guildford , UK.
Matthew
M
Reaney
Regeneron Pharmaceuticals, Inc , Tarrytown, New York , USA.
Chieh-I
CI
Chen
Sanofi , Guildford , UK.
Clare W J
CW
Proudfoot
Sanofi , Chilly-Mazarin , France.
Sophie
S
Guillonneau
Sanofi Genzyme , Bridgewater, New Jersey , USA.
Deborah
D
Bauer
Regeneron Pharmaceuticals, Inc , Tarrytown, New York , USA.
Erin
E
Mangan
Regeneron Pharmaceuticals, Inc , Tarrytown, New York , USA.
Neil M H
NM
Graham
Sanofi Genzyme , Bridgewater, New Jersey , USA.
Hubert
H
van Hoogstraten
Sanofi Genzyme , Bridgewater, New Jersey , USA.
Yong
Y
Lin
Universidad Autónoma de Chihuahua , Chihuahua , Mexico.
César
C
Pacheco-Tena
Metroplex Clinical Research Center and University of Texas Southwestern Medical Center , Dallas, Texas , USA.
Roy
R
Fleischmann
Anti-TNF; DMARDs (biologic); Outcomes research; Patient perspective; Rheumatoid Arthritis