Evidence map›Paper›PMID 31673415›Full record

Trial reportRMD open2019

Safety and efficacy of switching from adalimumab to sarilumab in patients with rheumatoid arthritis in the ongoing MONARCH open-label extension.

Gerd R Burmester, Vibeke Strand, Andrea Rubbert-Roth, Howard Amital, Tatiana Raskina, Antonio Gómez-Centeno, Claudia Pena-Rossi, Leon Gervitz, Karthinathan Thangavelu, Gregory St John and 2 more

Registry-linked trialAbstract readClinical Trial, Phase III
In one paragraph

Trial report in RMD open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02332590 (A Randomized, Double-blind, Parallel-group Study Assessing the Efficacy and Safety of Sarilumab Monotherapy Versus Adalimumab Monotherapy in Patients With Rheumatoid Arthritis), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02332590 phase3completednot on this map

A Randomized, Double-blind, Parallel-group Study Assessing the Efficacy and Safety of Sarilumab Monotherapy Versus Adalimumab Monotherapy in Patients With Rheumatoid Arthritis

TypeinterventionalSponsorSanofiRan2015 to 2020Enrolled369ConditionsRheumatoid ArthritisArmsSarilumab, Adalimumab, Placebo (for sarilumab), Placebo (for adalimumab)
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Interleukin-6 in Rheumatoid Arthritis.International journal of molecular sciences · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Gerd R BurmesterDepartment of Rheumatology and Clinical Immunology, Charité - Medical University Berlin, Free University, and Humboldt University Berlin, Berlin, Germany.ORCID 0000-0001-7518-1131
Vibeke StrandDepartment of Immunology and Rheumatology, Stanford University, Palo Alto, California, USA.
Andrea Rubbert-RothKlinik für Rheumatologie, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Howard AmitalDepartment of Medicine 'B' and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.
Tatiana RaskinaFaculty of Therapeutics, Kemerovo State Medical Academy of Roszdrav, Kemerovo, Russian Federation.
Antonio Gómez-CentenoServicio de Reumatología, Parc Taulí Hospital Universitari, Barcelona, Spain.
Claudia Pena-RossiImmunology and Inflammation, Sanofi, Bridgewater, New Jersey, USA.
Leon GervitzMedical Operations and Effectiveness, Sanofi Genzyme, Cambridge, Massachusetts, USA.
Karthinathan ThangaveluBiostatistics, Sanofi Genzyme, Cambridge, Massachusetts, USA.
Gregory St JohnMedical Affairs, Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA.
Susan BoklageMedical Affairs, Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA.
Mark C GenoveseImmunology and Rheumatology, Stanford University Medical Center, Palo Alto, California, USA.ORCID 0000-0001-5294-4503

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Evaluate open-label sarilumab monotherapy in patients with rheumatoid arthritis switching from adalimumab monotherapy in MONARCH (NCT02332590); assess long-term safety and efficacy in patients continuing sarilumab during open-label extension (OLE). Methods: During the 48-week OLE, patients received sarilumab 200 mg subcutaneously once every 2 weeks. Safety (March 2017 cut-off) and efficacy, including patient-reported outcomes, were evaluated. Results: In the double-blind phase, patients receiving sarilumab or adalimumab monotherapy showed meaningful improvements in disease activity; sarilumab was superior to adalimumab for improving signs, symptoms and physical function. Overall, 320/369 patients completing the 24-week double-blind phase entered OLE (155 switched from adalimumab; 165 continued sarilumab). Sarilumab safety profile was consistent with previous reports. Treatment-emergent adverse events were similar between groups; no unexpected safety signals emerged in the first 10 weeks postswitch. Among switch patients, improvement in disease activity was evident at OLE week 12: 47.1%/34.8% had changes ≥1.2 in Disease Activity Score (28 joints) (DAS28)-erythrocyte sedimentation rate/DAS28-C-reactive protein. In switch patients achieving low disease activity (LDA: Clinical Disease Activity Index (CDAI) ≤10; Simplified Disease Activity Index (SDAI) ≤11) by OLE week 24, 70.7%/69.5% sustained CDAI/SDAI LDA at both OLE weeks 36 and 48. Proportions of switch patients achieving CDAI ≤2.8 and SDAI ≤3.3 by OLE week 24 increased through OLE week 48. Improvements postswitch approached continuation-group values, including scores ≥normative values. Conclusions: During this OLE, there were no unexpected safety issues in patients switching from adalimumab to sarilumab monotherapy, and disease activity improved in many patients. Patients continuing sarilumab reported safety consistent with prolonged use and had sustained benefit.

Indexed as

Drug SubstitutionAdalimumabAdultAgedAntibodies, Monoclonal, HumanizedAntirheumatic AgentsArthritis, RheumatoidBiomarkersFemaleHumansMaleMiddle AgedPatient Reported Outcome MeasuresPrognosisTreatment OutcomeAdalimumabAntibodies, Monoclonal, HumanizedAntirheumatic AgentsBiomarkerssarilumabDAS28disease activityDMARDs (biologic)rheumatoid arthritistreatment

Identifiers

PMID31673415
PMCPMC6802992

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.