Drug adherence to biologic DMARDS with a special emphasis on the benefits of subcutaneous abatacept.

Major advances in drug development have led to the introduction of biologic disease- modifying drugs for the treatment of rheumatoid arthritis, which has resulted in unprecedented improvement in outcomes for many patients. These agents have been found to be effective in reducing clinical signs and symptoms, improving radiological damage, quality of life, and functionality, and have also been found to have an acceptable safety profile. Despite this, drug adherence is unknown, which has huge health care and health-economic implications. Local and national guidelines exist for the use of biologics; however, its varied use is widespread. Although this may in part reflect differences in prescribing behavior, patient preference plays a key role. In this review we will explore the factors that contribute to patient preference for, and adherence to, biologic therapy for rheumatoid arthritis with emphasis on the subcutaneous preparation of abatacept, a T-cell costimulatory molecule blocker. Overall, subcutaneous administration is preferred by patients and this may well improve drug adherence.

Will treatment of rheumatoid arthritis with an IL-6R inhibitor help facilitate the 'age of remission'?

BACKGROUND: Rheumatoid arthritis (RA) is a chronic, inflammatory, systemic disease, which negatively influences patients' quality of life, work productivity and longevity. Current therapies include traditional and biologic disease-modifying antirheumatic drugs (DMARDs). Although these are effective for many, a substantial proportion of patients fail to respond to these agents, suffer from loss of efficacy and/or experience unpleasant side effects, highlighting the need for alternatives. OBJECTIVES/METHODS: To address how a greater proportion of RA patients may potentially achieve disease remission, we reviewed data on IL-6 as a therapeutic target. RESULTS/CONCLUSIONS: IL-6 is an important driver of RA pathogenesis, mediating both articular and systemic effects of the disease. Tocilizumab, an inhibitor of the IL-6 receptor (IL-6R), is beneficial in treating RA in a variety of clinical contexts. Evidence to date supports the use of tocilizumab, as monotherapy or combination therapy, as an effective approach to the treatment of RA. Here, we discuss key efficacy and safety data from the recently published Phase III trials.