Province: Manitoba
Indication: rheumatoid arthritis
Medication: tocilizumab (Actemra®)
Listing Status: Listed—CBC
Listing Criteria:
For the treatment of adult patients who have moderate to severe active rheumatoid arthritis and who
- failed treatment with at least 3 DMARD (disease-modifying antirheumatic drugs) therapies, one of which therapies must be either methotrexate or leflunomide, unless intolerance or contraindication to these therapies is documented; and
- previously tried at least one combination of DMARD therapies.
Request for coverage must be made by a Manitoba physician who is a specialist in rheumatology
CDR Recommendation:
The Canadian Expert Drug Advisory Committee (CEDAC) recommends that tocilizumab be listed for adults with moderate-to-severely active rheumatoid arthritis (RA) who have failed to respond to an adequate trial of both disease-modifying antirheumatic drugs (DMARDs) and a tumour necrosis factor (TNF)-alpha inhibitor.
Tocilizumab is to be started at 4 mg/kg every four weeks in combination with methotrexate or other DMARDs; tocilizumab monotherapy may be used in cases where methotrexate is inappropriate or not tolerated. Response to tocilizumab should be assessed after 16 weeks of treatment and therapy be continued only if there is a clinical response.