Efficacy and safety of anti-TNF multivalent NANOBODY® compound 'ozoralizumab' without methotrexate co-administration in patients with active rheumatoid arthritis: A 52-week result of phase III, randomised, open-label trial (NATSUZORA trial)

Mod Rheumatol. 2023 Aug 25;33(5):875-882. doi: 10.1093/mr/roac126.

Abstract

Objectives: The aim is to assess the efficacy and safety of a 52-week subcutaneous ozoralizumab treatment at 30 and 80 mg without methotrexate (MTX) in active rheumatoid arthritis.

Methods: This randomised, open-label, multicentre phase III trial randomly allocated 140 patients in 2:1 ratio as subcutaneous ozoralizumab at 30 or 80 mg every 4 weeks for 52 weeks without MTX.

Results: Both groups administered ozoralizumab at 30 and 80 mg showed good clinical improvement. The American College of Rheumatology response rates were high at Week 24 and maintained through 52 weeks. The ozoralizumab groups also showed good improvement in other end points, and improvements observed from Week 1 were maintained through 52 weeks. Improvements in many efficacy assessments were similar between doses. No deaths were reported, and serious adverse events occurred in a total of 20 patients in the ozoralizumab groups. Increased antidrug antibodies were observed in approximately 40% of patients in the ozoralizumab groups, and 27.7% of the patients in the 30 mg group were neutralising antibody-positive.

Conclusions: Ozoralizumab, at 30 and 80 mg, demonstrated significant therapeutic effects without MTX, and the efficacy was maintained for 52 weeks with active rheumatoid arthritis. Ozoralizumab showed an acceptable tolerability profile over 52 weeks.

Keywords: Japanese; VHH antibody; ozoralizumab; rheumatoid arthritis; tumour necrosis factor alpha inhibitor.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antirheumatic Agents* / adverse effects
  • Arthritis, Rheumatoid* / drug therapy
  • Double-Blind Method
  • Drug Therapy, Combination
  • Humans
  • Methotrexate / adverse effects
  • Treatment Outcome
  • Tumor Necrosis Factor Inhibitors / therapeutic use

Substances

  • Methotrexate
  • Tumor Necrosis Factor Inhibitors
  • Antirheumatic Agents
  • Antibodies, Monoclonal