The US Food and Drug Administration (FDA) has granted Breakthrough Therapy Designation (BTD) to Roche's Actemra/Roactemra (tocilizumab) for systemic sclerosis (SSc).

This designation is designed to expedite the development and review of medicines intended to treat serious diseases, and to help ensure patients have access to them as soon as possible. Roche also initiated a global phase 3 study in SSc (NCT02453256).

In addition, new data from the U-ACT-EARLY and TENDER studies in patients with early rheumatoid arthritis (RA) and systemic juvenile idiopathic arthritis (sJIA), respectively, as well as results from the phase 2 faSScinate study in SSc will be presented this week at the annual congress of the European League Against Rheumatism (EULAR 2015), Rome, June 10-13.

“Close to 500,000 people worldwide have benefited from treatment with Actemra/Roactemra since initial approval over a decade ago. The breadth of our study results at EULAR, ranging from arthritis in adults and children to a rare inflammatory disorder, underscores our commitment to helping people with debilitating autoimmune diseases,” said Sandra Horning, M.D., Roche’s head of Global Product Development and chief medical officer. “These new data further demonstrate the efficacy and safety of Actemra/Roactemra in multiple diseases, including use as a single therapy in early RA.”
Actemra/Roactemra has been proven to help people with RA protect against damage to their joints and have a better quality of life. Clinical research has shown that effective treatment during the early phase of the disease may prevent irreversible damage to joints and long-term disability. In patients who were diagnosed less than a year prior to study enrollment with no history of any previous disease-modifying therapy, Actemra/Roactemra nearly doubled sustained remission (SR) rates with comparable results as monotherapy and combination. SR rates were 84 per cent for Actemra/Roactemra monotherapy, 86 per cent for Actemra/Roactemra + methotrexate (MTX), and 44 per cent for MTX alone. Median time to SR was seen in just over two months: 9.9 weeks for Actemra/Roactemra + MTX and 12.7 weeks for Actemra/Roactemra monotherapy (MTX alone results were not measurable). The safety profile was comparable with previously reported data. Full results from the U-ACT-EARLY study will be presented as an oral presentation at EULAR 2015.

Juvenile idiopathic arthritis (JIA) affects approximately 100 in every 100,000 children,10 of which sJIA – a rare and severe form of childhood arthritis – accounts for 10 to 20 per cent of all cases. The phase 3 TENDER study demonstrated that 97 per cent of patients achieved 30 per cent improvement in their disease symptoms (JIA ACR30) and 64 per cent achieved 90 per cent improvement (JIA ACR90).  

Actemra/Roactemra’s efficacy was maintained through week 260 (4.9 years) with no change in the observed safety profile. Full results will be presented as a poster presentation at EULAR 2015. Actemra/Roactemra is the only agent approved for the treatment of both sJIA and polyarticular juvenile idiopathic arthritis (pJIA) in patients two years and older.

SSc is a rare, chronic disorder characterised by blood vessel abnormalities, as well as degenerative changes and scarring in the skin, joints, and internal organs. The incidence of SSc is difficult to measure but is estimated to affect approximately 2.5 million people worldwide, and has the highest mortality of any rheumatic disease. FDA BTD status for ACTEMRA/RoACTEMRA was granted based on data from the phase 2 faSScinate study.  48 week data from faSScinate will be presented as an oral presentation at EULAR 2015. While the primary endpoint of improvement in skin thickening at 24 weeks, as assessed by Rodnan skin score, was not met a meaningful trend was observed. In this second part of the study, there was continued improvement in skin thickening between weeks 24 and 48.5. The overall adverse event profile between both groups was comparable. The extent and severity of skin thickness correlates to disease worsening, increased disability and decreased survival. Based on these phase 2 results and the unmet need in patients with SSc, for which there are no approved disease modifying therapeutic options, Roche initiated a global phase 3 multicentre, randomised, double-blind, placebo-controlled study (NCT02453256).

Actemra/Roactemra is the first anti-IL-6 receptor biologic approved in intravenous (IV) and subcutaneous formulations, for the treatment of adult patients with moderate to severe active RA. Actemra/Roactemra can be used alone or with MTX in adults who are intolerant to, or have failed to respond to other anti-rheumatic medications. In the most recent update to the EULAR RA management guidelines, Actemra/Roactemra is highlighted as the only biologic that has been repeatedly demonstrated to be superior as a monotherapy over MTX or other conventional disease-modifying anti-rheumatic drugs (DMARDs).

Actemra/Roactemra IV formulation is approved in most major countries for polyarticular juvenile idiopathic arthritis (pJIA) or systemic juvenile idiopathic arthritis (sJIA) in children two years of age and older. In Europe, Actemra/Roactemra is also approved for use in patients with severe, active and progressive RA (early RA) who previously have not been treated with MTX. 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 more than 100 countries worldwide.

Headquartered in Basel, Switzerland, Roche is a leader in research-focused healthcare with combined strengths in pharmaceuticals and diagnostics.