Long-term persistence with rituximab in patients with rheumatoid arthritis

Abstract

ObjectivesTo investigate the long term persistence of rituximab (RTX) in a large observational RA cohort, investigate persistence of RTX when used as a first or second line biologic DMARD (bDMARD), to characterize subsequent bDMARD treatment following RTX. MethodsPatients with RA starting treatment with RTX (MabThera) between 2008 and 2011 were recruited into the British Society for Rheumatology Biologics Register for RA. Duration of RTX treatment over the first 4 years after initiation was estimated via Kaplan-Meier estimates and the reason for discontinuation was ascertained. Subsequent bDMARD use following RTX discontinuation was characterised. Treatment survival in bDMARD-naïve (first line RTX use) and experienced (second line RTX use) cohorts was described.ResultsOne thousand six hundred and twenty-nine patients were recruited (1371 bDMARD-experienced and 258 bDMARD-naïve). Sixty percent of the whole cohort remained on RTX after 4 years. Ineffectiveness (46%) and death (24%) were the most common reason for RTX discontinuation. RTX discontinuation was associated with RF negativity for the bDMARD-experienced cohort. Of those that discontinued RTX, 46% initiated treatment with another bDMARD, with tocilizumab being the most common.ConclusionThis large study of patients initiating RTX treatment for severe RA found that 60% persisted with treatment after 4 years. This study also identified that RTX is tolerated well when used as a first or second line bDMARD.

<p>Real-World Patient Experience of Switching Biologic Treatment in Inflammatory Arthritis and Ulcerative Colitis – A Systematic Literature Review</p>

“…Of the 70 included studies, 19 were full-text articles, 7,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] while 51 were conference abstracts. Study characteristics are described in Supplementary Table 6.…”

“…Study characteristics are described in Supplementary Table 6. 28 studies were performed in patients with IA; 18,19,26-28,30-36,47,49-51,55-57, 59-63,67,79,80,83 25 in patients with RA; 7,16,17,23,24,37,39,40,[42][43][44][45]53,54,58,66,68,70,[73][74][75][76][77][78]84 5 in patients with AS; 21,25,46,48,65 4 in patients with PsA; 41,64,71,81 4 in patients with UC; 22,69,72,82 2 in patients with IBD (with results reported separately for UC); 38,52 and one in patients with SpA. 29 Most studies were retrospective (n=37), while 28 were prospective and one was cross-sectional.…”

“…Among the studies including patients with IA, 21 studies included some form of PRO, 18,20,21,23,24,27,[29][30][31]36,48,49,54,57,59,65,75,77,78,80,84 of which 10 studies reported PROs prior to the switch only and therefore did not provide any information on the patient experience of switching treatment. 20,21,23,24,[29][30][31]49,59,78 The PRO measurement tools used are summarized in Figure 3.…”

“…Among the studies including patients with IA, 21 studies included some form of PRO, 18,20,21,23,24,27,[29][30][31]36,48,49,54,57,59,65,75,77,78,80,84 of which 10 studies reported PROs prior to the switch only and therefore did not provide any information on the patient experience of switching treatment. 20,21,23,24,[29][30][31]49,59,78 The PRO measurement tools used are summarized in Figure 3. The most commonly used tool was the Health Assessment Questionnaire (HAQ) (12 studies), 18,20,23,24,31,48,49,54,65,75,77,84 while the least common measurement methods were Routine Assessment of Patient Index Data 3 (RAPID3) and Treatment Satisfaction Questionnaire for Medication (TSQM), each of which were used in one study only.…”

“…20,21,23,24,[29][30][31]49,59,78 The PRO measurement tools used are summarized in Figure 3. The most commonly used tool was the Health Assessment Questionnaire (HAQ) (12 studies), 18,20,23,24,31,48,49,54,65,75,77,84 while the least common measurement methods were Routine Assessment of Patient Index Data 3 (RAPID3) and Treatment Satisfaction Questionnaire for Medication (TSQM), each of which were used in one study only. 48 No study on patients with UC presented data on PROs before or after treatment switch.…”