1
|
Ho Lee Y, Gyu Song G. Comparison of the efficacy and safety of tocilizumab, sarilumab, and olokizumab in patients with active rheumatoid arthritis: a network meta-analysis of randomized controlled trials. Z Rheumatol 2024; 83:97-106. [PMID: 36607422 DOI: 10.1007/s00393-022-01315-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study compared the relative efficacy and safety of olokizumab, tocilizumab, and sarilumab in rheumatoid arthritis (RA) patients who were intolerant or responding inadequately to methotrexate (MTX). METHODS We performed a Bayesian network meta-analysis to combine direct and indirect evidence from randomized controlled trials (RCTs) to examine the efficacy and safety of olokizumab, tocilizumab, and sarilumab in RA patients who were intolerant or responding inadequately to MTX. RESULTS Six RCTs comprising 4439 patients met the inclusion criteria. Tocilizumab, sarilumab, olokizumab, and adalimumab treatments achieved a significant American College of Rheumatology 20% (ACR20) response rate compared with placebo. However, tocilizumab was associated with the most favorable surface area using the cumulative ranking curve (SUCRA) for the ACR20 response rate. The ranking probability based on the SUCRA indicated that tocilizumab treatment had the highest probability of providing the best ACR20 response rate, followed by sarilumab, olokizumab every 2 weeks (Q2W), olokizumab Q4W, adalimumab 40 mg, and placebo. The ACR50 and 70 response rates showed a distribution pattern similar to that of the ACR20 response rate. However, olokizumab Q4W had a higher ranking probability than olokizumab Q2W. The SUCRA rating showed that the placebo was the best intervention with the least adverse events (AEs) and withdrawal due to AEs, followed by interleukin‑6 inhibitors. CONCLUSION Tocilizumab, sarilumab, and olokizumab are more effective than adalimumab and have similar efficacy and safety in RA patients with inadequate responses to MTX.
Collapse
Affiliation(s)
- Young Ho Lee
- Department of Rheumatology, Korea University College of Medicine, Seoul, Korea (Republic of).
- Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, 02841, Seongbuk-gu, Seoul, Korea (Republic of).
| | - Gwan Gyu Song
- Department of Rheumatology, Korea University College of Medicine, Seoul, Korea (Republic of)
| |
Collapse
|
2
|
El Fattah Amer A, Mousa D. Sarilumab use in severe Coronavirus Disease 2019 pneumonia. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2023. [DOI: 10.4103/ecdt.ecdt_77_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
|
3
|
Marino A, Munafò A, Augello E, Bellanca CM, Bonomo C, Ceccarelli M, Musso N, Cantarella G, Cacopardo B, Bernardini R. Sarilumab Administration in COVID-19 Patients: Literature Review and Considerations. Infect Dis Rep 2022; 14:360-371. [PMID: 35645219 PMCID: PMC9149900 DOI: 10.3390/idr14030040] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 02/04/2023] Open
Abstract
Two years have passed since WHO declared a pandemic state for SARS-CoV-2 infection. COVID-19 pathogenesis consists of a first viral phase responsible for early symptoms followed by an inflammatory phase, cytokine-mediated, responsible for late-onset manifestations up to ARDS. The dysregulated immune response has an outstanding role in the progression of pulmonary damage in COVID-19. IL-6, through the induction of pro-inflammatory chemokines and cytokines, plays a key role in the development and maintenance of inflammation, acting as a pioneer of the hyperinflammatory condition and cytokine storm in severe COVID-19. Therefore, drugs targeting both IL-6 and IL-6 receptors have been evaluated in order to blunt the abnormal SARS-CoV-2-induced cytokine release. Sarilumab, a high-affinity anti-IL-6 receptor antibody, may represent a promising weapon to treat the fearsome hyperinflammatory phase by improving the outcome of patients with moderate-to-severe COVID-19 pneumonia. Further prospective and well-designed clinical studies with larger sample sizes and long-term follow-up are needed to assess the efficacy and the safety of this therapeutic approach to achieve improved outcomes in COVID-19.
Collapse
Affiliation(s)
- Andrea Marino
- Department of Biomedical and Biotechnological Science (BIOMETEC), University of Catania, 95123 Catania, Italy; (A.M.); (C.B.); (N.M.)
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, 95123 Catania, Italy; (M.C.); (B.C.)
| | - Antonio Munafò
- Department of Biomedical and Biotechnological Science, Section of Pharmacology, University of Catania, 95123 Catania, Italy; (E.A.); (C.M.B.); (G.C.); (R.B.)
- Correspondence:
| | - Egle Augello
- Department of Biomedical and Biotechnological Science, Section of Pharmacology, University of Catania, 95123 Catania, Italy; (E.A.); (C.M.B.); (G.C.); (R.B.)
| | - Carlo Maria Bellanca
- Department of Biomedical and Biotechnological Science, Section of Pharmacology, University of Catania, 95123 Catania, Italy; (E.A.); (C.M.B.); (G.C.); (R.B.)
| | - Carmelo Bonomo
- Department of Biomedical and Biotechnological Science (BIOMETEC), University of Catania, 95123 Catania, Italy; (A.M.); (C.B.); (N.M.)
| | - Manuela Ceccarelli
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, 95123 Catania, Italy; (M.C.); (B.C.)
| | - Nicolò Musso
- Department of Biomedical and Biotechnological Science (BIOMETEC), University of Catania, 95123 Catania, Italy; (A.M.); (C.B.); (N.M.)
| | - Giuseppina Cantarella
- Department of Biomedical and Biotechnological Science, Section of Pharmacology, University of Catania, 95123 Catania, Italy; (E.A.); (C.M.B.); (G.C.); (R.B.)
| | - Bruno Cacopardo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, 95123 Catania, Italy; (M.C.); (B.C.)
| | - Renato Bernardini
- Department of Biomedical and Biotechnological Science, Section of Pharmacology, University of Catania, 95123 Catania, Italy; (E.A.); (C.M.B.); (G.C.); (R.B.)
- Unit of Clinical Toxicology, Policlinico G. Rodolico, School of Medicine, University of Catania, 95123 Catania, Italy
| |
Collapse
|
4
|
Liu J, Ting JP, Al-Azzam S, Ding Y, Afshar S. Therapeutic Advances in Diabetes, Autoimmune, and Neurological Diseases. Int J Mol Sci 2021; 22:ijms22062805. [PMID: 33802091 PMCID: PMC8001105 DOI: 10.3390/ijms22062805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 02/08/2023] Open
Abstract
Since 2015, 170 small molecules, 60 antibody-based entities, 12 peptides, and 15 gene- or cell-therapies have been approved by FDA for diverse disease indications. Recent advancement in medicine is facilitated by identification of new targets and mechanisms of actions, advancement in discovery and development platforms, and the emergence of novel technologies. Early disease detection, precision intervention, and personalized treatments have revolutionized patient care in the last decade. In this review, we provide a comprehensive overview of current and emerging therapeutic modalities developed in the recent years. We focus on nine diseases in three major therapeutics areas, diabetes, autoimmune, and neurological disorders. The pathogenesis of each disease at physiological and molecular levels is discussed and recently approved drugs as well as drugs in the clinic are presented.
Collapse
Affiliation(s)
- Jinsha Liu
- Protein Engineering, Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA; (J.L.); (J.P.T.); (Y.D.)
| | - Joey Paolo Ting
- Protein Engineering, Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA; (J.L.); (J.P.T.); (Y.D.)
| | - Shams Al-Azzam
- Professional Scientific Services, Eurofins Lancaster Laboratories, Lancaster, PA 17605, USA;
| | - Yun Ding
- Protein Engineering, Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA; (J.L.); (J.P.T.); (Y.D.)
| | - Sepideh Afshar
- Protein Engineering, Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA; (J.L.); (J.P.T.); (Y.D.)
- Correspondence:
| |
Collapse
|
5
|
Boyce EG, Rogan EL, Vyas D, Prasad N, Mai Y. Sarilumab: Review of a Second IL-6 Receptor Antagonist Indicated for the Treatment of Rheumatoid Arthritis. Ann Pharmacother 2018; 52:780-791. [DOI: 10.1177/1060028018761599] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Major Objectives: To review the efficacy, safety, and economics of sarilumab, an interleukin-6 (IL-6) receptor antagonist, in the treatment of rheumatoid arthritis (RA). Data Sources: PubMed (1966 to January 2018), Clinicaltrials.gov (January 2018), and Scopus (1970 to January 2018) were searched using sarilumab, Kevzara, REGN88, and SAR153191. Study Selection and Data Extraction: Human studies published in peer-reviewed publications in English were the primary sources for efficacy and safety. Data Synthesis: Data from randomized, double-blind, controlled, published clinical studies weeks demonstrated statistically significantly higher American College of Rheumatology (ACR) 20, ACR50, and Disease Activity Score-28 (DAS28) remission response rates and improvements in DAS28 and Health Assessment Questionnaire–Disability Index scores for sarilumab monotherapy versus adalimumab monotherapy (P < 0.05) and for sarilumab versus placebo in patients receiving methotrexate or other conventional synthetic disease-modifying antirheumatic drugs (DMARDs); P < 0.05. The ACR20 and ACR50 response rates were, respectively, 56-72% and 35-46% for sarilumab, 58% and 30% for adalimumab, and 33-34% and 15-18% for placebo. DAS28 remission rates were 20-34% for sarilumab, 7% for adalimumab, and 7-10% for placebo. Sarilumab has a higher risk for neutropenia than tocilizumab, the other IL-6 inhibitor, but a lower risk for dyslipidemia, injection site reactions, and gastrointestinal perforation. The acquisition costs of sarilumab are expected to be similar to those of most other biologic DMARDs. Conclusion: Sarilumab is an alternative to biologic DMARDs or targeted synthetic DMARDs in patients with moderate to severely active RA who have not responded adequately to prior conventional synthetic DMARDs or tumor necrosis factor-α inhibitors.
Collapse
Affiliation(s)
| | | | - Deepti Vyas
- University of the Pacific, Stockton, CA, USA
| | - Neel Prasad
- University of the Pacific, Stockton, CA, USA
| | - Yvonne Mai
- University of the Pacific, Stockton, CA, USA
| |
Collapse
|
6
|
Semerano L, Thiolat A, Minichiello E, Clavel G, Bessis N, Boissier MC. Targeting IL-6 for the treatment of rheumatoid arthritis: Phase II investigational drugs. Expert Opin Investig Drugs 2014; 23:979-99. [DOI: 10.1517/13543784.2014.912276] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Luca Semerano
- Inserm UMR 1125,
74, rue Marcel Cachin 93017 Bobigny, France
- Sorbonne Paris Cité – Université Paris 13,
74, rue Marcel Cachin 93017 Bobigny, France
- Assistance Publique – Hôpitaux de Paris (AP-HP) Groupe Hospitalier Avicenne – Jean Verdier – René Muret, Service de Rhumatologie,
125 rue de Stalingrad 93017 Bobigny, France
| | - Allan Thiolat
- Inserm UMR 1125,
74, rue Marcel Cachin 93017 Bobigny, France
- Sorbonne Paris Cité – Université Paris 13,
74, rue Marcel Cachin 93017 Bobigny, France
| | - Emeline Minichiello
- Inserm UMR 1125,
74, rue Marcel Cachin 93017 Bobigny, France
- Sorbonne Paris Cité – Université Paris 13,
74, rue Marcel Cachin 93017 Bobigny, France
- Assistance Publique – Hôpitaux de Paris (AP-HP) Groupe Hospitalier Avicenne – Jean Verdier – René Muret, Service de Rhumatologie,
125 rue de Stalingrad 93017 Bobigny, France
| | - Gaëlle Clavel
- Inserm UMR 1125,
74, rue Marcel Cachin 93017 Bobigny, France
- Sorbonne Paris Cité – Université Paris 13,
74, rue Marcel Cachin 93017 Bobigny, France
- Service de Médecine Interne, Fondation Ophtalmologique A de Rothschild,
75019 Paris, France
| | - Natacha Bessis
- Inserm UMR 1125,
74, rue Marcel Cachin 93017 Bobigny, France
- Sorbonne Paris Cité – Université Paris 13,
74, rue Marcel Cachin 93017 Bobigny, France
| | - Marie-Christophe Boissier
- Inserm UMR 1125,
74, rue Marcel Cachin 93017 Bobigny, France
- Sorbonne Paris Cité – Université Paris 13,
74, rue Marcel Cachin 93017 Bobigny, France
- Assistance Publique – Hôpitaux de Paris (AP-HP) Groupe Hospitalier Avicenne – Jean Verdier – René Muret, Service de Rhumatologie,
125 rue de Stalingrad 93017 Bobigny, France
| |
Collapse
|
7
|
Huizinga TWJ, Fleischmann RM, Jasson M, Radin AR, van Adelsberg J, Fiore S, Huang X, Yancopoulos GD, Stahl N, Genovese MC. Sarilumab, a fully human monoclonal antibody against IL-6Rα in patients with rheumatoid arthritis and an inadequate response to methotrexate: efficacy and safety results from the randomised SARIL-RA-MOBILITY Part A trial. Ann Rheum Dis 2013; 73:1626-34. [PMID: 24297381 PMCID: PMC4145418 DOI: 10.1136/annrheumdis-2013-204405] [Citation(s) in RCA: 167] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives To evaluate safety and efficacy of weekly (qw) and every other week (q2w) dosing of sarilumab, a fully human anti-interleukin 6 receptor α (anti-IL-6Rα) monoclonal antibody, for moderate-to-severe rheumatoid arthritis (RA). Methods In this dose-ranging study, patients (n=306) with active RA, despite methotrexate, were randomly assigned to placebo or one of five subcutaneous doses/regimens of sarilumab: 100 mg q2w, 150 mg q2w, 100 mg qw, 200 mg q2w, 150 mg qw for 12 weeks, plus methotrexate. The primary end point was ACR20 at Week 12. Secondary endpoints included ACR50, ACR70, Disease Activity Score in 28 joints (C reactive protein). Safety, pharmacokinetics, pharmacodynamics and efficacy in population subgroups were assessed. Results The proportion of patients achieving an ACR20 response compared with placebo was significantly higher for sarilumab 150 mg qw (72.0% vs 46.2%, multiplicity adjusted p=0.0203). Higher ACR20 responses were also attained with 150 mg q2w (67%; unadjusted (nominal) p=0.0363) and 200 mg q2w (65%; unadjusted p=0.0426) versus placebo. Sarilumab ≥150 mg q2w reduced C reactive protein, which did not return to baseline between dosing intervals. Infections were the most common adverse event; none were serious. Changes in laboratory values (neutropenia, transaminases and lipids) were consistent with reports with other IL-6Rα inhibitors. Conclusions Sarilumab improved signs and symptoms of RA over 12 weeks in patients with moderate-to-severe RA with a safety profile similar to reports with other IL-6 inhibitors. Sarilumab 150 mg and sarilumab 200 mg q2w had the most favourable efficacy, safety and dosing convenience and are being further evaluated in Phase III.
Collapse
Affiliation(s)
- Tom W J Huizinga
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Roy M Fleischmann
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Martine Jasson
- Division of Rheumatology, Department of Medicine, University of Texas Southwestern Medical Center and Metroplex Clinical Research Center, Dallas, Texas, USA
| | - Allen R Radin
- Department of Research and Development, Sanofi, Paris, France
| | | | - Stefano Fiore
- Regeneron Pharmaceuticals, Inc., Tarrytown, New York, USA
| | - Xiaohong Huang
- Department of Research and Development, Sanofi, Bridgewater, New Jersey, USA
| | | | - Neil Stahl
- Regeneron Pharmaceuticals, Inc., Tarrytown, New York, USA
| | - Mark C Genovese
- Department of Immunology and Rheumatology, Stanford University Medical Center, Palo Alto, California, USA
| |
Collapse
|