Thursday, November 19, 2015

Iguratimod at the ACR 2015 Meeting in San Francisco


There has been one publication on iguratimod at the ACR 2015 Annual Meeting in San Francisco. Iguratimod is a novel disease modifying anti-rheumatic drug (DMARD); chemical formula: N-(3-Formamido-4-oxo-6-phenoxy-4H-chromen-7-yl)-methanesulfonamide. Iguratimod is characterized by inhibitory effects on immunoglobulin production in B cells as well as inhibiting cytokine production. Its' mode of action comes by suppression of nuclear factor kappa B (NF-kB) activation. As I have already written on Iguratimod before, please look for the links below. 2012 there had been three studies, 2013 one study at the EULAR Meeting in Madrid (a study by a Chinese group), only one study at the ACR 2013 Meeting, but three studies at the EULAR 2014 meeting in Paris, also three studies at the ACR 2014 Meeting and the 2015 EULAR Meeting in Rome. But let’s look at the study now.

Tsuneo Kondo and colleagues presented: “Clinical and Radiographic Outcome of Iguratimod for Rheumatoid Arthritis”. Results: “[…] DAS28-ESR and SDAI decreased significantly from 4.49±1.33 to 3.12±1.08 and from 18.5±10.9 to 8.3±6.34 in 52 weeks respectively (P < 0.01). Remission and LDA rate in DAS28-ESR were 29.0% and 24.2%. HAQ-DI score also decreased from 1.2±0.8 to 0.85±0.79. The percentage of patients with no radiographic progression (ΔmTSS < 0.5) was 56.8%, while that of rapid radiographic progression (ΔTSS > 5) was 13.5%. The mean estimated yearly progression was 9.9 ± 15.6 at baseline. After 52 weeks of IGU treatment, the mean change was significantly reduced to 1.2 ± 2.5(P < 0.01). […]”. So, the author’s concluded: „IGU reduced disease activity and radiographic progression with RA patients. IGU is generally safe and tolerable and may have a good cost effectiveness. So iguratimod be a new useful option as small molecule DMARDs.

Iguratimod has shown to be a promising candidate for treatment of active rheumatoid arthritis and might become a needed alternative in the conventional (traditional) DMARD class. Iguratimod is approved in Japan and hopefully it will be approved in the rest of the world soon. We now have data on radiographic progression, so the drug is one step nearer to approval. But iguratimod is making progress in to little and too few steps. The sponsor of studies should more committed.

References:
Kondo T, Shibata A, Sakai R, Kikuchi J, Chino K, Okuyama A, Takei H, Amano K. Clinical and Radiographic Outcome of Iguratimod for Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/clinical-and-radiographic-outcome-of-iguratimod-for-rheumatoid-arthritis/. Accessed November 18, 2015.

Links:
Iguratimod at the EULAR Meeting 2012

Iguratimod at the EULAR Meeting 2013

Iguratimod at the ACR 2013 Meeting

Iguratimod at the EULAR 2014 Meeting


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