Disproportionate articular pain is a frequent phenomenon in rheumatoid arthritis and responds to treatment with sarilumab

Choy, Ernest ORCID: https://orcid.org/0000-0003-4459-8609, Bykerk, Vivian, Lee, Yvonne C., van Hoogstraten, Hubert, Ford, Kerri, Praestgaard, Amy, Perrot, Serge, Pope, Janet and Sebba, Anthony 2023. Disproportionate articular pain is a frequent phenomenon in rheumatoid arthritis and responds to treatment with sarilumab. Rheumatology 62 (7) , pp. 2386-2393. 10.1093/rheumatology/keac659

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Abstract

Objectives In some patients with RA, joint pain is more severe than expected based on the amount of joint swelling [referred to as disproportionate articular pain (DP)]. We assessed DP prevalence and the effects of sarilumab, an IL-6 inhibitor, on DP. Methods Data from RA patients treated with placebo or 200 mg sarilumab in the phase 3 randomized controlled trials (RCTs) MOBILITY and TARGET, adalimumab 40 mg or sarilumab 200 mg in the phase 3 RCT MONARCH and sarilumab 200 mg in open-label extensions (OLEs) were used. DP was defined as an excess tender 28-joint count (TJC28) over swollen 28-joint count (SJC28) of ≥7 (TJC28 − SJC28 ≥ 7). Treatment response and disease activity were determined for patients with and without DP. Results Of 1531 sarilumab 200 mg patients from RCTs, 353 (23%) had baseline DP. On average, patients with DP had higher 28-joint DAS using CRP (DAS28-CRP) and pain scores than patients without DP, whereas CRP levels were similar. After 12 and 24 weeks, patients with baseline DP treated with sarilumab were more likely to be DP-free than those treated with placebo or adalimumab. In RCTs, more sarilumab-treated patients achieved low disease activity vs comparators, regardless of baseline DP status. In OLEs, patients were more likely to lose rather than gain DP status. Conclusion About one-quarter of patients with RA experienced DP, which responded well to sarilumab. These data support the concept that other mechanisms (potentially mediated via IL-6) in addition to inflammation may contribute to DP in RA.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Oxford University Press
ISSN:	1462-0324
Date of First Compliant Deposit:	4 January 2023
Date of Acceptance:	10 November 2022
Last Modified:	16 Aug 2023 16:28
URI:	https://orca.cardiff.ac.uk/id/eprint/155403

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