A retrospective review of the persistence on <scp>bDMARD</scp>s prescribed for the treatment of rheumatoid arthritis in the Australian population

Jones, Graeme; Hall, Stephen; Bird, Paul; Littlejohn, Geoffrey; Tymms, Kathleen; Youssef, Peter; Chung, Eric; Barrett, Rina; Button, Peter

doi:10.1111/1756-185x.13243

Cited by 21 publications

(19 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies on data from other registers, focusing on treatment with bDMARDs other than abatacept reported better response and survival on drug in bionaïve patients as compared with bDMARD experienced patients [27][28][29][30][31]. Several studies described the same pattern for abatacepttreated patients [32][33][34], which is in line with our finding, although we suggest that this may partly be due to confounding by other factors.…”

Section: Discussionsupporting

confidence: 91%

“…Of note, sex did not predict HAQ response in the present study. Our data on the benefit of methotrexate are in line with those from an Australian retrospective cohort [33] and the ACTION study, where association of methotrexate with a longer survival on abatacept was also demonstrated in patients previously exposed to bDMARDs [34]. The predictive value of pain for survival on abatacept was reported in the ACTION study too, with results going in the same direction as in our study [34].…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Abatacept in rheumatoid arthritis: survival on drug, clinical outcomes, and their predictors—data from a large national quality register

et al. 2020

View full text Add to dashboard Cite

Background: There are limited data regarding efficacy of abatacept treatment for rheumatoid arthritis (RA) outside clinical trials. Quality registers have been useful for observational studies on tumor necrosis factor inhibition in clinical practice. The aim of this study was to investigate clinical efficacy and tolerability of abatacept in RA, using a national register. Methods: RA patients that started abatacept between 2006 and 2017 and were included in the Swedish Rheumatology Quality register (N = 2716) were investigated. Survival on drug was estimated using Kaplan-Meier analysis. The European League Against Rheumatism (EULAR) good response and Health Assessment Questionnaire (HAQ) response (improvement of ≥ 0.3) rates (LUNDEX corrected for drug survival) at 6 and at 12 months were assessed. Predictors of discontinuation were investigated by Cox regression analyses, and predictors of clinical response by logistic regression. Significance-based backward stepwise selection of variables was used for the final multivariate models. Results: There was a significant difference in drug survival by previous biologic disease-modifying antirheumatic drug (bDMARD) exposure (p < 0.001), with longer survival in bionaïve patients. Men (hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.74-0.98) and methotrexate users (HR 0.85, 95% CI 0.76-0.95) were less likely to discontinue abatacept, whereas a high pain score predicted discontinuation (HR 1.14 per standard deviation, 95% CI 1.07-1.20). The absence of previous bDMARD exposure, male sex, and a low HAQ score were independently associated with LUNDEX-corrected EULAR good response. The absence of previous bDMARD exposure also predicted LUNDEXcorrected HAQ response. Conclusions: In this population-based study of RA, bDMARD naïve patients and male patients were more likely to remain on abatacept with a major clinical response.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Abatacept in rheumatoid arthritis: survival on drug, clinical outcomes, and their predictors—data from a large national quality register

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In addition, patients in the present analysis with any change in corticosteroid dose had an overall reduction in daily dose from baseline to month 6 [mean (SD) change, − 2.2 (9.0) mg]. Corticosteroid-sparing effects of TCZ have similarly been observed in other real-world studies of TCZ use in routine practice conducted in Japan [9], France [25, 26], Australia [27], Germany [28], and the USA [29]. Together, these findings show that both TCZ monotherapy and combination therapy reduce the need for corticosteroids in patients with RA.…”

Section: Discussionsupporting

confidence: 65%

Tocilizumab Patterns of Use, Effectiveness, and Safety in Patients with Rheumatoid Arthritis: Final Results from a Set of Multi-National Non-Interventional Studies

Casado¹,

Czirják

Taylor

et al. 2019

Rheumatol Ther

Self Cite

View full text Add to dashboard Cite

Introduction The objective of this study was to observe the patterns of usage, efficacy, and safety of tocilizumab (TCZ) in clinical practice in patients with rheumatoid arthritis. Methods Data on the real-world usage, efficacy, and safety of TCZ were collected from patients during routine follow-up visits conducted over a 6-month period. Patients were grouped by previous exposure to biologic therapies (biologic exposed vs. biologic naive). Results Of 1912 patients enrolled from 16 countries, 639 (33.4%) received TCZ monotherapy and 1273 (66.6%) received TCZ combination therapy. At baseline, 1073 patients (56.1%) were biologic naive and 839 (43.9%) were biologic exposed. At 6 months, 1504 patients (78.7%) continued to receive TCZ treatment, with no descriptive differences in retention rates between biologic-exposed and biologic-naive patients and between patients receiving TCZ monotherapy or combination therapy. Dose and use of methotrexate and prednisone were reduced at 6 months. Efficacy at 6 months, including patient-reported outcomes, was demonstrated in both biologic-naive and biologic-exposed groups. Adverse events (AEs) occurred in 817 patients [42.7%; incidence rate: 179 events per 100 patient-years (PY)], and serious AEs (SAEs) occurred in 118 patients (6.2%; 17 events per 100 PY), with comparable rates of AEs and SAEs between subgroups. Conclusion In routine clinical practice, TCZ discontinuation rates were low and unaffected by prior use of biologics. Effectiveness was similar between groups, and no new safety signals were identified. Funding F. Hoffmann-La Roche. Electronic supplementary material The online version of this article (10.1007/s40744-019-0150-x) contains supplementary material, which is available to authorized users.

show abstract

“…Several observational studies and biologic registries have contributed to a wealth of available data regarding the long-term efficacy and safety of these agents [18, 19, 21, 23, 25]. Furthermore, observational studies have highlighted the importance of real-world persistence, defined as the time from the index dose to the time of switching to a different biologic or the time of the last dose/censoring, as a surrogate for treatment effectiveness and a factor to consider when choosing between agents [20, 28]. These studies showed that first-line abatacept treatment had higher persistence rates than TNFis [20, 28].…”

Section: Discussionmentioning

confidence: 99%

Persistence rates of abatacept and TNF inhibitors used as first or second biologic DMARDs in the treatment of rheumatoid arthritis: 9 years of experience from the Rhumadata® clinical database and registry

et al. 2019

View full text Add to dashboard Cite

Background Treatment persistence is an important consideration when selecting a therapy for chronic conditions such as rheumatoid arthritis (RA). We assessed the long-term persistence of abatacept or a tumor necrosis factor inhibitor (TNFi) following (1) inadequate response to a conventional synthetic disease-modifying antirheumatic drug (first-line biologic agent) and (2) inadequate response to a first biologic DMARD (second-line biologic agent). Methods Data were extracted from the Rhumadata® registry for patients with RA prescribed either abatacept or a TNFi (adalimumab, certolizumab, etanercept, golimumab, or infliximab) who met the study selection criteria. The primary outcome was persistence to abatacept and TNFi treatment, as first- or second-line biologics. Secondary outcomes included the proportion of patients discontinuing therapy, reasons for discontinuation, and predictors of discontinuation. Persistence was defined as the time from initiation to discontinuation of biologic therapy. Baseline characteristics were compared using descriptive statistics; cumulative persistence rates were estimated using Kaplan-Meier methods, compared using the log-rank test. Multivariate Cox proportional hazard models were used to compare the persistence between treatments, controlling for baseline covariates. Results Overall, 705 patients met the selection criteria for first-line biologic agent initiation (abatacept, n = 92; TNFi, n = 613) and 317 patients met the criteria for second-line biologic agent initiation (abatacept, n = 105; TNFi, n = 212). There were no clinically significant differences in baseline characteristics between the treatments with either first- or second-line biologics. Persistence was similar between the first-line biologic treatments ( p = 0.7406) but significantly higher for abatacept compared with TNFi as a second-line biologic ( p = 0.0001). Mean (SD) times on first-line biologic abatacept and TNFi use were 4.53 (0.41) and 5.35 (0.20) years, and 4.80 (0.45) and 2.82 (0.24) years, respectively, as second-line biologic agents. The proportion of patients discontinuing abatacept and TNFi in first-line was 51.1% vs. 59.5% ( p = 0.1404), respectively. In second-line, it was 57.1% vs. 74.1% ( p = 0.0031). The main reasons for stopping both treatments were inefficacy and adverse events. Conclusions Abatacept and TNFi use demonstrated similar persistence rates at 9 years as a first-line biologic agent. As a second-line biologic agent, abatacept had better persistence rates over a TNFi.

show abstract

A retrospective review of the persistence on bDMARDs prescribed for the treatment of rheumatoid arthritis in the Australian population

Cited by 21 publications

References 26 publications

Abatacept in rheumatoid arthritis: survival on drug, clinical outcomes, and their predictors—data from a large national quality register

Abatacept in rheumatoid arthritis: survival on drug, clinical outcomes, and their predictors—data from a large national quality register

Tocilizumab Patterns of Use, Effectiveness, and Safety in Patients with Rheumatoid Arthritis: Final Results from a Set of Multi-National Non-Interventional Studies

Persistence rates of abatacept and TNF inhibitors used as first or second biologic DMARDs in the treatment of rheumatoid arthritis: 9 years of experience from the Rhumadata® clinical database and registry

Contact Info

Product

Resources

About