The U.S. Food and Drug Administration recently approved the second infusible anti–tumor necrosis factor (TNF) treatment for patients with moderate to severe rheumatoid arthritis (RA). Golimumab for infusion (Simponi Aria), in combination with methotrexate, is the first treatment of its kind approved in more than a decade, and phase III studies showed it significantly improved physical function and inhibited the progression of structural damage.
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Rheumatologist Christopher Morris, MD, says the new treatment is a viable option for RA patients, but adds it’s too early to consider it a “major” improvement over established anti-TNF agents.
“It is nice to have a second, infusible, anti-TNF agent. There are many patients that, by virtue of their insurance coverage, an infusible medication is more accessible and affordable than a self-injected medication,” says Dr. Morris, who practices in Kingsport, Tenn.
Dr. Morris’ main concerns with the new treatment are twofold: whether neutralizing antibodies seen in patients who received infliximab will “similarly neutralize this medication” and whether it is any better “than the other infusible anti-TNF agent that we have, which is also infused every eight weeks.”
“Had this drug been able to be used every 12 weeks, it would have certainly provided us a real step up,” he adds. “However, a recent study showed that when this interval was tried, inflammatory markers started to rise again after eight weeks.”
For now, the new treatment provides rheumatologists a second option and alternative administration for patients suffering from moderate to severe RA.
“There are patients who prefer infusion drugs,” Dr. Morris says. “Some insurance plans make infused drugs financially better for the patient. … In the same way that Bristol-Myers Squibb has come out with two different modes of administration for [abatacept], Janssen now has presented us two different ways to give golimumab to our patients. Whether one mode is better than the other, and whether either form is superior to those already out there, remains to be seen, in my view.”
Richard Quinn is a freelance writer in New Jersey.