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Related Experiment Video

Updated: Nov 4, 2025

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Comparative Efficacy (DAS28 Remission) of Targeted Immune Modulators for Rheumatoid Arthritis: A Network

Jennie H Best1, Yuting Kuang2, Yilin Jiang3

  • 1Genentech, Inc., South San Francisco, CA, USA.

Rheumatology and Therapy
|May 26, 2021
PubMed
Summary

Tocilizumab significantly improves remission rates in rheumatoid arthritis patients compared to other targeted immune modulators (TIMs). This finding holds true for both new and experienced patients, whether used with conventional disease-modifying antirheumatic drugs (cDMARDs) or alone.

Keywords:
Disease activity scoreNetwork meta-analysisRemissionRheumatoid arthritisTargeted immune modulators

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Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Rheumatoid arthritis (RA) management often requires targeted immune modulators (TIMs) for patients with inadequate response to conventional disease-modifying antirheumatic drugs (cDMARDs).
  • Efficacy of different TIMs varies, necessitating comparative analyses in distinct patient populations.

Purpose of the Study:

  • To compare the relative efficacy of various TIMs in adults with moderate-to-severe RA.
  • To evaluate TIM efficacy in both TIM-naïve/mixed and TIM-experienced patient groups.
  • To assess treatment outcomes based on combination therapy with cDMARDs or monotherapy.

Main Methods:

  • A fixed-effects Bayesian network meta-analysis (NMA) of 41 randomized controlled trials (RCTs) was conducted.
  • Included RCTs compared TIMs against each other, cDMARDs, or placebo.
  • Efficacy was defined as achieving remission (DAS28 score < 2.6) at 12 and 24 weeks.

Main Results:

  • In TIM-naïve/mixed populations at 12 weeks, all TIMs combined with cDMARDs were more effective than cDMARDs alone.
  • Intravenous tocilizumab demonstrated the greatest effect (OR 19.36; 95% CrI 11.01-38.16) at 12 weeks.
  • Both intravenous and subcutaneous tocilizumab showed the highest odds of remission at 24 weeks, with similar trends observed in monotherapy and TIM-experienced populations.

Conclusions:

  • Tocilizumab significantly increases the likelihood of achieving remission (DAS28 < 2.6) at both 12 and 24 weeks.
  • This benefit was observed across TIM-naïve/mixed and TIM-experienced populations, with or without cDMARDs.
  • Tocilizumab demonstrated superior efficacy compared to most other TIMs, including Janus kinase (JAK) inhibitors.