Actemra for RA linked to risk of serious side effects: Study

  • Actemra (tocilizumab) is a biologic used to treat rheumatoid arthritis (RA).
  • In a large study, patients on Actemra had significantly greater risk of bowel perforations (i.e., holes in the intestines) vs. conventional treatments.1
  • When taking Actemra, patients and healthcare professionals need to be mindful of symptoms such as abdominal pain or discomfort.


RA is one of the most common chronic inflammatory diseases, often treated with conventional DMARDs and/or a biologic such as a TNF-inhibitor, or a non-TNF-inhibitor.

One of these biologics, Actemra, was tied to a 4.5-times greater risk of perforations in the colon or appendix – as reported in a large study published in the Annals of the Rheumatic Diseases by Dr. Strangfeld and colleagues.1

A perforated colon or appendix is a serious side effect. In this study, 24% of patients with such a perforation died within 30 days.1

The study analyzed data from more than 13,000 patients with RA enrolled in the German biologics register, RABBIT. Patients were treated with conventional DMARDs or one of the following biologics:1

TNF-inhibitors Non-TNF-inhibitors
Humira (adalimumab)
Cimzia (certolizumab pegol)
Enbrel (etanercept)
Simponi (golimumab)
Remicade (infliximab)
Orencia (abatacept)
Rituxan (rituximab)
Actemra (tocilizumab)
 
 

Perforations in the colon or appendix were 5-times more common in patients taking Actemra vs. other TNF-inhibitors or Orencia. This trend was not seen for other treatments included in this study.1

Overall incidences of colon or appendix perforations with Actemra were relatively low. About 2.7 cases were reported per 1,000 patient-years.

Bottom line

  • If you or a loved one is on Actemra, you should know about the greater risk of colon or appendix perforations.
  • Be vigilant about this rare but serious side effect, especially when taking Actemra.
  • Talk to your doctor or nurse about any abdominal pain or discomfort you may feel, and ask them about the possible risks of intestinal perforation.

DMARD = disease modifying anti-rheumatic drug.
Original article: Strangfeld A, et al. Ann Rheum Dis 2016;0:1-7. A paid subscription may be required.

References: 1. Strangfeld A, et al. Ann Rheum Dis 2016;0:1-7.

Photo adapted from original by Andres Rueda, used under license.

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