Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Adalimumab (ADA) is an effective medication in the treatment of rheumatoid arthritis (RA). However, it is not clear whether the use of ADA is associated with altered use of concomitant RA medications. A study was conducted to examine changes in the use of concomitant RA medications after initiation of ADA.
Methods:
The Consortium of Rheumatology Researchers of North America, Inc. (CORRONA) registry is a multi-center, longitudinal rheumatology database (for physical examination data, laboratory tests, and patient outcomes) from more than 90 academic and private sites across the US. We examined RA patients enrolled in CORRONA between March 2002-September 2011 who initiated ADA and had at least one follow-up visit. RA-related concomitant medications (methotrexate [MTX], prednisone, non-steroidal anti-inflammatory drugs [NSAIDs], intra-articular joint injections [IAs]), antidepressant use, comorbidities (high blood pressure, cardiovascular disease, lymphoma, other cancers, liver disorders, asthma, chronic obstructive pulmonary disease, diabetes mellitus, psoriasis), and demographics (age, sex, disease duration, insurance status) were examined. Trends in medication use over time were estimated using random effects logistic regression adjusting for sex, age, the number of comorbidities at initiation, and the use of ADA at each time point. Analyses included all patients with follow-up at 6, 12, 18, or 24 months after ADA initiation.
Results:
Of the 1,173 patients who initiated treatment with ADA, available follow-up decreased over time to 417 patients by 24 months. The mean (SD) age and disease duration were 54.2 (12.3) and 10.1 (9.2) years, respectively, and 79.3% of patients were female. At baseline, 67% of patients were treated concomitantly with MTX, 30% with prednisone, 61% with NSAIDs, 8% with IAs, and 30% with antidepressants. Multivariable trend analysis revealed MTX and prednisone use to decrease over 24 months following ADA initiation (table). Controlling for time of follow-up and other factors, patients with ≥2 comorbidities were less likely to use MTX and more likely to use antidepressants than those with no comorbidities. The number of comorbidities was unrelated to prednisone, NSAID, or IA usage.
Conclusion:
Among RA patients who initiated treatment with ADA, MTX and prednisone decreased over 24 months. This suggests the clinical efficacy of ADA in RA disease control across a medically diverse patient population.
|
|
Multivariable Trend Analysis |
Influence of Comorbidities |
||
|
Concomitant Medication |
24 Months vs. Initiation OR (95% CI) |
P-Value |
≥2 vs. 0 Comorbidities OR (95% CI) |
P-Value |
|
MTX |
0.68 (0.48 – 0.95) |
0.05 |
0.48 (0.29 – 0.80) |
0.01 |
|
Prednisone |
0.61 (0.43 – 0.86) |
0.003 |
0.90 (0.56 – 1.44) |
NS |
|
NSAIDs |
0.77 (0.57 – 1.04) |
NS |
1.15 (0.75 – 1.76) |
NS |
|
Antidepressants |
1.00 (0.71 – 1.40) |
NS |
2.45 (1.55 – 3.88) |
<0.001 |
|
Intra-articular injections |
1.05 (0.67 – 1.64) |
NS |
1.06 (0.63 – 1.77) |
NS |
Abbreviations: OR, odds ratio; CI, confidence interval; MTX, methotrexate; NSAIDs, non-steroidal anti-inflammatory drugs; NS, not significant.
Disclosure:
D. Furst,
Amgen, Janssen, Roche, and UCB,
2,
Amgen, Janssen, Roche, and UCB,
5;
N. Mozaffarian,
Abbott Laboratories,
1,
Abbott Laboratories,
3;
S. Grant,
Axio Research LLC,
3;
M. Cifaldi,
Abbott Laboratories,
1,
Abbott Laboratories,
3;
J. Clewell,
Abbott Laboratories,
3,
Abbott Laboratories,
1;
J. M. Kremer,
Corrona,
4;
J. Shaw,
Abbott Laboratories,
3,
Abbott Laboratories,
1.
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