About ACTEMRA monotherapy
Approximately 30% of RA patients receiving a biologic are treated with biologic monotherapy1–4
The European League Against Rheumatism (EULAR) guidelines recommend a target of remission or low disease activity (LDA) as the desired outcome for all patients, using a treatment algorithm based on initiation with methotrexate (MTX) therapy (or other synthetic disease-modifying anti-rheumatic drug [DMARD] when MTX contraindications or intolerance are present).5
In patients with an inadequate response to DMARDs (DMARD-IR), the guidelines recommend starting a biological DMARD in combination with MTX.5
Biologic combination therapy with MTX is the standard treatment approach in RA.1–4
Registry data from various countries have shown that approximately 1 in 3 RA patients receiving a biologic will receive it as monotherapy.1–4
Treatment with biologic monotherapy may occur under a variety of circumstances:
- Patients prescribed their first biologic as monotherapy due to contraindication to MTX/other DMARDs.6
- Patients prescribed combination therapy who decline treatment with MTX or do not comply with treatment regimes.7
- Patients with intolerance to MTX necessitating a step-down from combination therapy.6,8
- Patients achieving good disease control on combination therapy allowing a step-down to biologic monotherapy.9
References:
1. Yazici Y, et al. Bull NYU Hosp Jt Dis 2008; 66:77–85.
2. Soliman MM, et al. Ann Rheum Dis 2011; 70:583–589.
3. Listing J, et al. Arthritis Res Ther 2006; 8:R66.
4. Askling J, et al. Ann Rheum Dis 2007; 66:1339–1344.
5. Smolen JS, et al. Ann Rheum Dis 2010; 69:964–975.
6. Taylor A & Jones G. Clin Invest 2011; 1:1291–1300.
7. de Thurah A, et al. Scand J Rheumatol 2010; 39:197–205.
8. Salliot & van der Heijde D. Ann Rheum Dis 2009; 68:1100–1104.
9. Emery P, et al. Arthritis Rheum 2010; 62:674–682.