Rheumatoid arthritis patients given new treatment hope
New data has revealed that tens of thousands of rheumatoid arthritis (RA) sufferers who cannot take the current mainstay of treatment, methotrexate (MTX), are almost four times as likely to achieve disease remission from RoActemra (tocilizumab) compared to patients taking the most widely prescribed anti TNF, Humira (adalimumab).
Patients treated with RoActemra also achieved a significantly greater reduction in their disease signs and symptoms after six months, which includes painful joint swelling and difficulty in completing everyday tasks.
This is the first study of its kind to demonstrate superiority between two approved biological drugs in RA patients with an intolerance or inadequate response to MTX.
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MTX is the current standard of care for patients with RA in the UK and has been used in treatment since the late 1980’s.
However, of the estimated 46,000 RA patients on a biologic treatment in the UK, approximately one in three are not taking MTX, as they are intolerant to the drug or where treatment with MTX for other reasons is inappropriate.
For those RA patients who cannot tolerate MTX, side effects can include nausea and vomiting, diarrhoea, mouth ulcers, hair loss and skin rashes – perhaps explaining why 30 percent of all biologics patients are on biological monotherapy.
The results, presented today at the annual European Congress of Rheumatology, of the pioneering global head-to-head ADACTA (ADalimumab ACTemrA) study among 326 patients, including five trial centres in the UK, confirm tocilizumab’s superior efficacy over adalimumab offering an alternative treatment option for the thousands of RA patients unable to take MTX.
In a separate study, tocilizumab is the first and only biologic to have published data to demonstrate its superiority as a biologic monotherapy treatment over MTX in standard RA clinical efficacy parameters at 24 weeks.
Tocilizumab works differently from other RA treatments by targeting IL-6 receptors which are found throughout the body.
In RA, excess IL-6 is linked to inflammation of the joints, joint destruction, and many systemic manifestations such as fatigue and anaemia.
Inhibiting IL-6 has an effect on systemic and local RA symptoms, providing a holistic approach to treating the condition.
Tocilizumab therapy has an established safety profile as demonstrated over 69,330 patient years.
The most common adverse reactions reported in clinical studies were upper respiratory tract infection, nasopharyngitis, headache, elevated blood pressure, and increased liver enzymes.
The serious adverse reactions reported in clinical studies include serious infections, gastrointestinal perforations and hypersensitivity reactions including anaphylaxis.
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Introducing Dosis - the AI powered dosing platform
Cloud-based platform Dosis uses AI to help patients and clinicians tailor their medication plans. Shivrat Chhabra, CEO and co-founder, tells us how it works.
When and why was Dosis founded?
Divya, my co-founder and I founded Dosis in 2017 with the purpose of creating a personalised dosing platform. We see personalisation in so many aspects of our lives, but not in the amount of medication we receive. We came across some research at the University of Louisville that personalised the dosing of a class of drugs called ESAs that are used to treat chronic anaemia. We thought, if commercialised, this could greatly benefit the healthcare industry by introducing precision medicine to drug dosing.
The research also showed that by taking this personalised approach, less drugs were needed to achieve the same or better outcomes. That meant that patients were exposed to less medication, so there was a lower likelihood of side effects. It also meant that the cost of care was reduced.
What is the Strategic Anemia Advisor?
Dosis’s flagship product, Strategic Anemia Advisor (SAA), personalises the dosing of Erythropoiesis Stimulating Agents (ESAs). ESAs are a class of drugs used to treat chronic anaemia, a common complication of chronic kidney disease.
SAA takes into account a patient’s previous ESA doses and lab levels, determines the patient’s unique response to the drug and outputs an ESA dose recommendation to keep the patient within a specified therapeutic target range. Healthcare providers use SAA as a clinical decision support tool.
What else is Dosis working on?
In the near term, we are working on releasing a personalised dosing module for IV iron, another drug that’s used in tandem with ESAs to treat chronic anaemia. We’re also working on personalising the dosing for the three drugs used to treat Mineral Bone Disorder. We’re very excited to expand our platform to these new drugs.
What are Dosis' strategic goals for the next 2-3 years?
We strongly believe that personalised dosing will be the standard of care within the next decade, and we’re honored to be a part of making that future a reality. In the next few years, we see Dosis entering partnerships with other companies that operate within value-based care environments, where tools like ours that help reduce cost while maintaining or improving outcomes are extremely useful.
What do you think AI's greatest benefits to healthcare are?
If designed well, AI in healthcare allows for a practical and usable way to deploy solutions that would not be feasible otherwise. For example, it’s possible for someone to manually solve the mathematical equations necessary to personalise drug dosing, but it is just not practical. AI in healthcare offers an exciting path forward for implementing solutions that for so long have appeared impractical or impossible.