Same Class Rheumatoid Arthritis Drugs Equally Effective, Direct Switch Shows Benefit

Two TNF-inhibitors found equally effective treating RA patients.

Two rheumatoid arthritis (RA) drugs from the same class were compared for the first time in a large, multi-center study, demonstrating the treatments are equally effective, according to a study published in The Lancet.

Approximately 1000 volunteers were included in the EXXELERATE study, which compared the efficacy of 2 tumor necrosis factor (TNF) drugs, certolizumab pegol and adalimumab (with methotrexate in each case).

The results of the study showed that 2 randomized treatment groups had similar responses to the drugs after 12 and 104 weeks, demonstrating that they are equally effective.

Those who did not experience any benefits after 12 weeks were switched to the other drug. However, this time it was done without discontinuing the previous drug for an extended period.

The immediate switch-over brought a measurable improvement of the condition in 40% of volunteers, and a very good one in 10%, according to the researchers.

Although it’s been frequently recommended that patients who experience treatment failure with the TNF inhibitor be switched over to a drug in another class, the study results prove that this is unnecessary.

“If treatment fails, it is possible to switch over to a drug of the same class that still has a beneficial effect in many cases,” said lead study investigator Josef Smolen.

Smolen stated that if treatment with 1 particular drug does not demonstrate any improvement within 3 months, then it is possible to change over to the other drug immediately.

“This improves the quality of life for patients and saves costs, because ineffective biologic drugs can be discontinued after [a] short time and replaced by a new one,” Smolen said.