European approval for Roche’s tocilizumab for the treatment of giant cell arteritis (GCA)

Roche, a global pioneer in pharmaceuticals and diagnostics company, announced that the European Commission (EC) has approved Actemra/RoActemra (tocilizumab) for the treatment of giant cell arteritis (GCA), a chronic and potentially life-threatening autoimmune condition. Actemra/RoActemra is the first therapy approved for the treatment of GCA in Europe.

The European approval was based on the outcome of the phase III GiACTA study, which showed that a weekly dose of Actemra/RoActemra, initially combined with a six-month steroid taper, significantly increased the proportion of patients achieving sustained remission at one year (56%; p <0.0001) compared to a six-month steroid taper given alone (14%). The results of the phase III GiACTA study were recently published in the New England Journal of Medicine in July 2017.

In May 2017 Actemra/RoActemra was approved for the treatment of GCA by the US Food and Drug Administration (FDA) and New Zealand’s Medsafe.

GiACTA (NCT01791153) is a phase III, global, randomised, double-blind, placebo-controlled trial investigating the efficacy and safety of Actemra /RoActemra (tocilizumab) as a novel treatment for giant cell arteritis (GCA). It is the largest clinical trial ever conducted in GCA and the first to use blinded, variable-dose, variable-duration steroid regimens. The multicentre study was conducted in 251 patients across 76 sites in 14 countries. The primary and key secondary endpoints were evaluated at 52 weeks.

Giant cell arteritis (GCA) – also known as temporal arteritis (TA) – is a potentially life-threatening autoimmune condition. GCA has a global impact, usually affects those above the age of 50, and is two-to-three-times more likely to affect women than men.2 GCA is often difficult to diagnose because of the wide and variable spectrum of signs and symptoms. GCA can cause severe headaches, scalp tenderness, jaw pain and visual symptoms and if left untreated, can lead to blindness, aortic aneurysm or stroke.2 Treatment to date for people with GCA has been limited to high-dose steroids that play a role as an effective ‘emergency’ treatment option to prevent damage such as vision loss. However, in some cases steroids are unable to maintain long-term disease control (flare-free remission).3,4,5 Due to the variability of symptoms, complexity of the disease and disease complications, people with GCA are often seen by several physicians including rheumatologists, ophthalmologists and neurologists.

Actemra/RoActemra is the first approved anti-IL-6 receptor biologic available in both intravenous (IV) and subcutaneous (SC) formulations for the treatment of adult patients with moderate to severe active rheumatoid arthritis (RA). Actemra/RoActemra can be used alone or with methotrexate (MTX) in adult RA patients who are intolerant to, or have failed to respond to, other anti-rheumatic medications. The extensive Actemra/RoActemra RA IV clinical development programme included five phase III clinical studies and enrolled more than 4,000 people with RA in 41 countries. The Actemra/RoActemra RA SC clinical development programme included two phase III clinical studies and enrolled more than 1,800 people with RA in 33 countries. In Europe, Actemra/RoActemra IV and SC is also approved for use in adult patients with severe, active and progressive RA who previously have not been treated with MTX. Actemra/RoActemra IV formulation is approved in most major countries for polyarticular juvenile idiopathic arthritis (pJIA) and systemic juvenile idiopathic arthritis (sJIA) in children two years of age and older. In the United States and New Zealand, Actemra/RoActemra subcutaneous injection is approved for the treatment of giant cell arteritis (GCA). Actemra/RoActemra is the first therapy approved for the treatment of adult patients with GCA.

Actemra/RoActemra is part of a co-development agreement with Chugai Pharmaceutical Co., Ltd and has been approved in Japan since April 2005. Actemra/RoActemra is approved in 116 countries worldwide.

Actemra/RoActemra is also being investigated in a global phase III multicentre, randomised, double-blind, placebo-controlled study (NCT02453256) for patients with systemic sclerosis (SSc) also known as scleroderma. Actemra/RoActemra was granted Breakthrough Therapy Designation for SSc by the FDA in June 2015.