NEW data presented at the European League Against Rheumatism (EULAR) meeting in Copenhagen suggests a significant benefit from using Roche's MabThera earlier in the treatment path for rheumatoid arthritis.

Results from the IMAGE study show that 2 x 1000 mg MabThera (rituximab) plus methotrexate achieved superior clinical and radiological response compared with methotrexate alone in patients with early active rheumatoid arthritis (RA) who are naive to methotrexate. Using MabThera in combination with standard first-line treatment methotrexate as the patient’s first biological therapy at this dose slowed joint damage after a year of treatment with virtually no progression after six months.

The IMAGE study also studied the effect of lower doses of rituximab (2 x 500 mg). Presenting the results at EULAR, lead investigator Paul-Peter Tak from the Academic Medical Center at the University of Amsterdam in The Netherlands said: “These results show significantly improved clinical outcomes and inhibition of joint damage with rituximab at higher doses that could be seen by six months. The lower doses improved clinical but not radiological outcomes."

The percentage of serious adverse events was similar across the treatment groups, but nearly twice as many patients taking rituximab (2 x 1000 mg) plus methotrexate achieved remission than those taking methotrexate alone.

Benefits at less cost?
Rheumatologist Professor John Isaacs of Newcastle University’s Institute of Cellular Medicine said: “These positive data clearly show the efficacy of using rituximab earlier in the RA treatment pathway”. Rituximab is not currently licensed for use in early RA, but is approved for use in combination with methotrexate to treat adults with severe forms of the disease in whom anti-TNFs have failed. Professor Isaacs added: “Inhibiting joint damage is vital when treating RA. Treating patients with the most appropriate drugs as early as possible is key to helping them continue to lead active and meaningful lives”.

General Manager of Roche Products Ltd UK, John Melville said: “This important new data, together with the fact that the annual cost of rituximab is significantly less than other biological treatments is positive news for patients with early aggressive RA, healthcare professionals and the National Health Service alike.”

By Rhonda Siddall