RoActemta (tocilizumab) is a biological antirheumatic drug with a new mechanism of action. The drug is a monoclonal antibody with interleukin 6 receptors. It is given as intravenous infusion every 4th week.
The registered indication is: moderate to severe rheumatoid arthritis in adult patients who had an inadequate response on treatment with one or more disease modifying drugs (DMARDS) or TNF-antagonists. RoActemra treatment is normally combined with methotrexate, but can be used as mono therapy.
The effect of RoActemra has been evaluated in 5 randomized studies. Numbers needed to treat (NNT) were, compared to placebo, 2,5-3 for a minimal response (ACR 20) and 5-10 for a very good response (ACR 70). Both the patient’s functional level and life quality were improved, like the CRP decreased markedly.
Unfortunately there are no randomized studies that compare RoActemra with other biological antirheumatic drugs.
Upper respiratory infections, headache, hypertension and increased ALAT are the most normal reported side effects (≥ 5 % of the patients). Serious infusion reactions are rare. S-Cholesterol increases. There are not sufficient data in assessing RoActemras influence on the risk of cardiovascular events or malignity.
One year of treatment with RoActemra costs approximately 140.000 Dkr. (AUP). This is more expensive than Remicade and MabThera in normal dose, but cheaper than Enbrel, Humira and Orencia? RoActemra is more than 300 times as expensive as oral treatment.
IRF states, that TNF-antagonists still is the first drug of choice among the biological antirheumatic drug. RoAcemta is a promising alternative, but should until no further notice be considered as a second drug of choice.