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How MabThera® is different

A unique B cell targeted therapy

MabThera® is a unique therapy for rheumatoid arthritis (RA), specifically targeting the B cell – a component of the immune system and a key factor in autoimmune-mediated inflammation. B cells trigger a variety of cellular processes, including generation of autoantibodies such as rheumatoid factor (RF), which are strongly implicated in the pathogenesis of RA.

There are a number of treatments available to manage the symptoms of RA and slow the progression of the disease. The most frequently prescribed biologic therapies are the tumour necrosis factor (TNF) inhibitors, but at least one-third of RA patients do not respond to TNF inhibitor therapy owing to inadequate efficacy, intolerance or compliance problems.1 In addition, 69–88% of RA patients fail to achieve remission after 1 year of treatment with TNF inhibitor agents.2,3

By targeting the B cell, MabThera® provides patients who have had an inadequate response to TNF inhibitor therapy with an alternative treatment option that has proven success for the treatment of RA.

Duration of effect

MabThera® is unique among RA therapies as it offers patients an unprecedented duration of response of at least 6 months with each treatment course. Responses are also maintained or improved with each repeat course of treatment, with more patients reaching DAS28 low disease activity and remission criteria with each further course of treatment.4

Timely repeat treatment before a patient’s disease activity flares is important to maximise treatment response. Findings from a recent study show that systematic monitoring of DAS28 scores can optimise repeat treatment timing with MabThera®. This strategy offers an opportunity to further reduce disease activity with a second course of treatment.5

Dosage and administration

A treatment course of MabThera® consists of two intravenous 1000 mg infusions given 2 weeks apart. The duration of effect of MabThera® allows for a highly convenient dosing schedule. Dosing schedules with TNF inhibitor therapies range from twice weekly to every 8 weeks, repeat courses of MabThera® are given at least 6 months apart, giving patients greater freedom from clinical intervention.

Efficacy in seropositive patients

Biomarkers predictive of treatment response allow therapy to be tailored to the patient, maximising the chance of success. Recent studies have identified that patients who are seropositive for the autoantibodies RF and anti-cyclic citrullinated peptide (anti-CCP) are two to three times more likely to achieve a significant improvement in the signs and symptoms of their disease with MabThera® therapy compared with seronegative patients.6 Approximately 80% of the RA patient population are seropositive.7

These are the first data to predict which patients have a greater probability of response to treatment with MabThera® and demonstrate the potential to make the management of RA more effective, safer and more cost-effective.

References

  1. Lawrence RC et al. Arthritis Rheum 1998;41:778–799.
  2. St Clair EW, et al. Arthritis Rheum 2004;50:3432–3443.
  3. van der Heijde D, et al. Ann Rheum Dis 2005;64:1582–1587.
  4. Keystone E, et al. Arthritis Rheum 2007;56:3896–3908.
  5. Finckh A, et al. Arthritis Rheum 2007;56:1417–1423.
  6. O’Dell JR. N Engl J Med 2004;350:2591–2602.
  7. Wilson D, et al. Can Fam Physician 2006;52:180–181.