Treatment Patterns Following Discontinuation of Adalimumab, Etanercept, and Infliximab in a US Managed Care Sample

Yeaw, Jason; Watson, Crystal; Fox, Kathleen M.; Schabert, Vernon F.; Goodman, Seth; Gandra, Shravanthi R.

doi:10.1007/s12325-014-0110-3

Cited by 22 publications

(26 citation statements)

References 18 publications

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“…106 Although a majority (61% to 66%) of patients restarted therapy within 3 months after initial discontinuation, the study confirmed that long gaps in the treatment of psoriasis, PsA, and RA are common (differences across the disease entities were insignificant). 106 Interestingly a significantly higher proportion of etanercept patients restarted etanercept within 3 months of discontinuation, compared with patients taking adalimumab or infliximab. 106 Also in 2014, Jani and colleagues 154 published results of a United Kingdom survey of 548 PsA patients, 94 of whom were switched at least once from a TNF-a inhibitor to a second or third PsA therapy.…”

Section: Treatment Resistance and Disease Recurrence/complications Trmentioning

confidence: 62%

“…Some investigators have suggested combination therapy (see later discussion) or switching from one biologic to another to improve clinical efficacy in PsA, although this has not been supported by clinical evidence. 105,106 A 2012 meta-analysis performed an indirect comparison of PsARC and patientreported outcomes for the available anti-TNF agents at that time (adalimumab, etanercept, golimumab, and infliximab). 107 Data from 20 publications representing 7 PsA clinical trials were analyzed; the investigators and did not find any statistically significant differences between the TNF-a inhibitors, 107 as the data compiled in Table 2 also suggest.…”

Section: Disease-modifying Antirheumatic Drugsmentioning

confidence: 99%

“…151 At the same time, an inadequate response to one TNF inhibitor does not predict resistance to other agents in the class, although inefficacy and discontinuation rates increase with successive switches. 106 New biologics can also be given at the next scheduled dosage date without a washout period, unless the discontinuation of the first biologic is due to an adverse effect. 49 Apremilast and emerging therapies (eg, secukinumab, brodalumab, ixekizumab, abatacept, tildrakizumab, guselkumab, tofacitinib, and tocilizumab) will become increasingly important for the treatment of patients who do not respond to TNF-a inhibitors and/or ustekinumab (even with long periods of treatment, eg, 3-6 months).…”

Section: Treatment Resistance and Disease Recurrence/complications Trmentioning

confidence: 99%

“…A retrospective review of more than 27,000 patients in the United States with PsA, RA, psoriasis, or AS who received etanercept, adalimumab, or infliximab, identified 53% of patients as having discontinued treatment over 1 to 3 years of follow-up. 106 Within 360 days of discontinuing the initial TNF inhibitor, 53.4% restarted the same drug, about 17% of patients switched to a second TNF-a inhibitor, and about 5.3% switched from the initial TNF-a agent to a non-TNF biological therapy. 106 Although a majority (61% to 66%) of patients restarted therapy within 3 months after initial discontinuation, the study confirmed that long gaps in the treatment of psoriasis, PsA, and RA are common (differences across the disease entities were insignificant).…”

Section: Treatment Resistance and Disease Recurrence/complications Trmentioning

confidence: 99%

“…106 Within 360 days of discontinuing the initial TNF inhibitor, 53.4% restarted the same drug, about 17% of patients switched to a second TNF-a inhibitor, and about 5.3% switched from the initial TNF-a agent to a non-TNF biological therapy. 106 Although a majority (61% to 66%) of patients restarted therapy within 3 months after initial discontinuation, the study confirmed that long gaps in the treatment of psoriasis, PsA, and RA are common (differences across the disease entities were insignificant). 106 Interestingly a significantly higher proportion of etanercept patients restarted etanercept within 3 months of discontinuation, compared with patients taking adalimumab or infliximab.…”

Section: Treatment Resistance and Disease Recurrence/complications Trmentioning

confidence: 99%

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Psoriatic Arthritis for the Dermatologist

Tintle¹,

Gottlieb²

2015

Dermatologic Clinics

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Section: Treatment Resistance and Disease Recurrence/complications Trmentioning

confidence: 62%

Section: Disease-modifying Antirheumatic Drugsmentioning

confidence: 99%

Section: Treatment Resistance and Disease Recurrence/complications Trmentioning

confidence: 99%

Section: Treatment Resistance and Disease Recurrence/complications Trmentioning

confidence: 99%

Section: Treatment Resistance and Disease Recurrence/complications Trmentioning

confidence: 99%

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Psoriatic Arthritis for the Dermatologist

Tintle¹,

Gottlieb²

2015

Dermatologic Clinics

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Systematic Review of Economic Evaluations of Cycling Versus Swapping Medications in Patients With Rheumatoid Arthritis After Failure to Respond to Tumor Necrosis Factor Inhibitors

Matusevich¹,

Suarez‐Almazor

Cantor

et al. 2020

Arthritis Care & Research

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Objective To systematically review the modeling approaches and quality of economic analyses comparing cycling tumor necrosis factor inhibitors (TNFi) to swapping to a therapy with a different mode of action in patients with rheumatoid arthritis whose initial TNFi failed. Methods We searched electronic databases, gray literature, and references of included publications until July 2017. Two reviewers independently screened citations. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Data regarding modeling methodology were extracted. Results We included 7 articles comprising 19 comparisons. Three studies scored ≥16 of 24 on the CHEERS checklist. Most models used a lifetime horizon, took a payer perspective, employed a 6‐month cycle length, and measured treatment efficacy in terms of the American College of Rheumatology improvement criteria. We noted possible sources of bias in terms of transparency and study sponsorship. In the cost‐utility comparisons, the median incremental cost‐effectiveness ratio was US $70,332 per quality‐adjusted life‐year for swapping versus cycling strategies. Rituximab was more effective and less expensive than TNFi in 7 of 11 comparisons. Abatacept (intravenous) compared to TNFi was less cost‐effective than rituximab. Common influential parameters in sensitivity analyses were the rituximab dosing schedule, assumptions regarding disease progression, and the estimation of utilities. Conclusion Differences in the design, key assumptions, and model structure chosen had a major impact on the individual study conclusions. Despite the existence of multiple reporting standards, there continues to be a need for more uniformity in the methodology reported in economic evaluations of cycling versus swapping strategies after TNFi in patients with rheumatoid arthritis.

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Treatment Sequences After Discontinuing a Tumor Necrosis Factor Inhibitor in Patients With Rheumatoid Arthritis: A Comparison of Cycling Versus Swapping Strategies

Matusevich

Duan

Zhao

et al. 2021

Arthritis Care & Research

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Objective To evaluate the sequences of tumor necrosis factor inhibitors (TNFi) and non‐TNFi used by rheumatoid arthritis (RA) patients whose initial TNFi therapy has failed, and to evaluate effectiveness and costs. Methods Using the Truven Health MarketScan Research database, we analyzed claims of commercially insured adult patients with RA who switched to their second biologic or targeted disease‐modifying antirheumatic drug between January 2008 and December 2015. Our primary outcome was the frequency of treatment sequences. Our secondary outcomes were the time to therapy discontinuation, drug adherence, and drug and other health care costs. Results Among 10,442 RA patients identified, 36.5% swapped to a non‐TNFi drug, most commonly abatacept (54.2%). The remaining 63.5% cycled to a second TNFi, most commonly adalimumab (41.2%). For subsequent switches of therapy, non‐TNFi were more common. Patients who swapped to a non‐TNFi were significantly older and had more comorbidities than those who cycled to a TNFi (P < 0.001). Survival analysis showed a longer time to discontinuation for non‐TNFi than for TNFi (median 605 days compared with 489 days; P < 0.001) when used after initial TNFi discontinuation, but no difference in subsequent switches of therapy. Although non‐TNFi were less expensive for adherent patients, cycling to a TNFi was associated with lower costs overall. Conclusion Even though patients are more likely to cycle to a second TNFi than swap to a non‐TNFi, those who swap to a non‐TNFi are more likely to persist with the therapy. However, cycling to a TNFi is the less costly strategy.

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Treatment Patterns Following Discontinuation of Adalimumab, Etanercept, and Infliximab in a US Managed Care Sample

Cited by 22 publications

References 18 publications

Psoriatic Arthritis for the Dermatologist

Psoriatic Arthritis for the Dermatologist

Systematic Review of Economic Evaluations of Cycling Versus Swapping Medications in Patients With Rheumatoid Arthritis After Failure to Respond to Tumor Necrosis Factor Inhibitors

Treatment Sequences After Discontinuing a Tumor Necrosis Factor Inhibitor in Patients With Rheumatoid Arthritis: A Comparison of Cycling Versus Swapping Strategies

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