Research in Brief

Abstract

Olokizumab, a humanised monoclonal antibody against interleukin-6, might be a safe and effective treatment for rheumatoid arthritis, according to a multicentre, double-blind, phase 3 trial by Josef Smolen and colleagues. 1648 patients with rheumatoid arthritis and an inadequate response to methotrexate were randomly assigned (2:2:2:1) to olokizumab (64 mg subcutaneously) every 2 weeks (n=464) or every 4 weeks (n=479), adalimumab every 2 weeks (40 mg; n=462), or placebo (n=243), alongside maintenance methotrexate. At week 12, 108 (44·4%) patients on placebo had an American College of Rheumatology 20 response (primary outcome) versus 326 (70·3%) on olokizumab every 2 weeks (difference 25·9%, 97·5% CI 17·1–34·1; p<0·001), 342 (71·4%) receiving olokizumab every 4 weeks (27·0%, 18·3–35·2; p<0·001), and 309 (66·9%) on adalimumab (22·5%, 14·8–29·8; p<0·001). 154 (63·4%) patients on placebo had at least one adverse event, versus 324 (70·0%) on olokizumab every 2 weeks, 338 (70·9%) on olokizumab every 4 weeks, and 302 (65·4%) on adalimumab. Seven deaths occurred: three on olokizumab every 2 weeks, two on olokizumab every 4 weeks, one on adalimumab, and one on placebo. Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UKThese findings warrant targeted cardiovascular prevention measures, in particular in younger patients with autoimmune diseases, and further research into pathophysiological mechanisms underlying these complications. Full-Text PDF