The U.S. Food and Drug Administration (FDA) has just approved a subcutaneous version of a drug called Actemra (tocilizumab) for treating patients with active polyarticular juvenile idiopathic arthritis (PJIA) who are over two years old, according to Biospace.

PJIA is a subtype of juvenile idiopathic arthritis (JIA). JIA is the most common cause of arthritis in children, affecting approximately one in every 1,000 children, but its cause remains unknown. 25-30% of JIA patients have the form PJIA. PJIA is an autoimmune disease thought to be caused by the body’s immune system becoming overactive and attacking healthy body cells causing damage and inflammation, and producing the symptoms associated with the condition. These symptoms differ between individuals, and over time. They include joint pain, stiffness, and swelling (usually of smaller joints), a loss of appetite, and tiredness. Periods of particularly intense symptoms known as ‘flare-ups’ can be brought on by various environmental, biological, and psychological factors such as stress, infection, and medication changes. The condition is often treated using painkillers such as paracetamol and codeine for pain, and a range of steroidal and non-steroidal drugs to reduce the underlying inflammation and stiffness that causes the pain.

The decision by the FDA to approve Actemra will give patients and doctors another option when treating the condition. The decision will allow patients to receive the drug subcutaneously (under the skin). The FDA previously approved the drug in 2013 for use in patients over two who had PJIA, via an intravenous (IV) administration.

This recent approval for subcutaneous administration of the drug follows a successful clinical trial on children with PJIA. The study was carried out over 52 weeks and enrolled 52 patients aged between one and seventeen.

Actemra acts on the interleukin-6 receptor to improve the symptoms of arthritis. It is also approved by the FDA for use on adult patients with rheumatoid arthritis, who have previously used a DMARD drug, but found that it doesn’t offer enough relief. The subcutaneous injection form of Actemra is also approved to treat adults with giant cell arteritis, and an IV form of the drug can be used on patients with systemic JIA, and CAR T cell-induced cytokine release syndrome.

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