Long-Term Real-Life Experience With Rituximab in Adult Finnish Patients With Rheumatoid Arthritis Refractory or With Contraindication to Anti–Tumor Necrosis Factor Drugs

Valleala, Heikki; Korpela, Markku; Hienonen-Kempas, Tuija; Immonen, Kai; Lähteenmäki, Jukka; Uusitalo, Tea; Komulainen, Riitta; Möttönen, Timo; Hannonen, Pekka

doi:10.1097/rhu.0000000000000166

Cited by 9 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on the registry data used in this study, RTX was administered every 7.98 months in maintenance treatment. Similar dosing interval of RTX was reported by Keystone et al [40], whereas mean dosing interval of RTX varied between 11 and 13 months in daily clinical practice in Finland according to the study by Valleala et al [41]. Therefore, a relatively short dosing interval used in this study might also be one reason to cause high costs of RTX treatment.…”

Section: Discussionsupporting

confidence: 81%

Cost-effectiveness of abatacept, tocilizumab and TNF-inhibitors compared with rituximab as second-line biologic drug in rheumatoid arthritis

et al. 2019

View full text Add to dashboard Cite

Objectives The objective of this study was to evaluate the cost-effectiveness of abatacept, tocilizumab, and tumor necrosis factor (TNF) inhibitors as compared with rituximab in Finnish rheumatoid arthritis patients, who have previously been treated with TNF inhibitors. Methods A patient-level simulation model was developed to predict costs and outcomes associated with four biological drugs (abatacept, tocilizumab, rituximab and TNF inhibitors) in the treatment of rheumatoid arthritis. Following lack of efficacy or adverse events, the patients were switched to another biological drug until all four options were exhausted. After that, the patients were assumed to receive a 6 th line treatment until death. The patients’ baseline characteristics and regression models used in the simulation were based on observational data from the National Register for Biological Treatments in Finland. Direct costs comprised drug costs, administration costs, costs of switching, and outpatient and inpatient care, while indirect costs included disability pension and sick leaves due to rheumatoid arthritis. Several subgroup and deterministic sensitivity analyses were conducted. Results Drug costs were the lowest for rituximab, but when administration costs and costs of switching were included, drug costs were the lowest for TNF inhibitors. Abatacept was associated with the highest drug costs, whereas rituximab was associated with the highest healthcare costs. In total, TNF inhibitors had the lowest direct costs, while rituximab had the highest direct costs. The amount of quality-adjusted life years (QALY) gained ranged from 9.405 for rituximab to 9.661 for TNF inhibitors. TNF inhibitors, abatacept, and tocilizumab were dominant in comparison to RTX. Conclusions TNF inhibitors, abatacept, and tocilizumab had lower costs and higher QALYs than rituximab, and therefore, they were dominant in comparison to rituximab. As TNF inhibitors had the lowest costs and highest QALYs, they were the most cost-effective treatment option.

show abstract

Section: Discussionsupporting

confidence: 81%

Cost-effectiveness of abatacept, tocilizumab and TNF-inhibitors compared with rituximab as second-line biologic drug in rheumatoid arthritis

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Tocilizumab was the most common subsequent bDMARD used in our cohort. The predominant use of this agent following RTX discontinuation has been reported previously [ 21 ] and is likely due to many factors, including the dates of availability of the various treatment options and also the fact that many patients had already failed more than one TNFi prior to starting RTX. That the bDMARD naïve patients were also less likely to receive a TNFi following RTX also supports that this group likely continued to have contraindications to TNFi.…”

Section: Discussionmentioning

confidence: 99%

Long-term persistence with rituximab in patients with rheumatoid arthritis

et al. 2018

View full text Add to dashboard Cite

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.

show abstract

“…Increasing evidence shows that on-demand, rather than fixed regular retreatment, is a reasonable schedule for long-term maintenance treatment of rituximab in patients with RA (30). The time interval for the average rituximab treatment course in our patients was 16 months, which was longer than in published literature (12,20,31). In several real-life observational studies, the average response duration of rituximab ranged from 7.8 months to 13 months.…”

Section: Discussionmentioning

confidence: 59%

Factors Determining Retreatment Time Interval of Rituximab in Korean Patients With Rheumatoid Arthritis

et al. 2021

View full text Add to dashboard Cite

Unlike other biologic agents for rheumatoid arthritis (RA) that are administered at regular intervals even without flare, rituximab can be administered according to the timing of retreatment determined by the physician. Recently, there has been a tendency to prefer on-demand administration for disease flares rather than regular retreatment. We aimed to investigate the retreatment patterns of rituximab in patients with RA and to identify factors associated with extension of the time interval between retreatment courses. This study included RA patients on rituximab treatment who were enrolled in the Korean Rheumatology Biologics registry (KOBIO) or treated at Ajou University Hospital. Previous or current concomitant conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), corticosteroids, number of previous biologic agents, withdrawal, and time intervals of rituximab retreatment were collected. In case of treatment failure, the reasons such as lack of efficacy, adverse events, and others, were also identified. A total of 82 patients were enrolled. The mean follow-up period from the first cycle of rituximab was 46.1 months, and the mean interval between the retreatment courses was 16.3 months. The persistent rates of rituximab after 5 years was 72.4%. Concomitant use of at least two csDMARDs (β = 4.672; 95% CI: 0.089–9.255, p = 0.046) and concomitant use of corticosteroids (β = 7.602; 95% CI: 0.924–14.28, p = 0.026) were independent factors for extending the time interval between the retreatment courses. In conclusion, RA patients treated with rituximab in Korea show high persistence rates. Concomitant use of two or more csDMARDs and concomitant use of corticosteroids with rituximab are associating factors of extending the retreatment time interval. These findings should be considered when selecting rituximab as a treatment for patients with RA.

show abstract

Long-Term Real-Life Experience With Rituximab in Adult Finnish Patients With Rheumatoid Arthritis Refractory or With Contraindication to Anti–Tumor Necrosis Factor Drugs

Cited by 9 publications

References 14 publications

Cost-effectiveness of abatacept, tocilizumab and TNF-inhibitors compared with rituximab as second-line biologic drug in rheumatoid arthritis

Cost-effectiveness of abatacept, tocilizumab and TNF-inhibitors compared with rituximab as second-line biologic drug in rheumatoid arthritis

Long-term persistence with rituximab in patients with rheumatoid arthritis

Factors Determining Retreatment Time Interval of Rituximab in Korean Patients With Rheumatoid Arthritis

Contact Info

Product

Resources

About