ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 432

Use Of Rituximab As Second Line Biologic Agent Compared With Adalimumab, Etanercept and Infliximab In Patients With Rheumatoid Arthritis. a Report From The Rhumadata® Clinical Database and Registry

Louis Bessette1, Denis Choquette2, Diane Sauvageau3, Boulos Haraoui4, Jean Pierre Pelletier2, Jean-Pierre Raynauld3, Edith Villeneuve3 and Louis Coupal2, 1Centre Hospitalier Universitaire de Québec, pavillon CHUL, Sainte-Foy, QC, Canada, 2Rheumatology, Institut de rhumatologie de Montréal (IRM), Montréal, QC, Canada, 3Rheumatology, Institut de Rhumatologie de Montréal, Montreal, QC, Canada, 4Rhumatology, Institut de Rhumatologie de Montréal, Montreal, QC, Canada

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Rheumatoid Arthritis Treatment - Small Molecules, Biologics and Gene Therapy I

Session Type: Abstract Submissions (ACR)

Background/Purpose: The order of use of biologic agents after failing a TNF inhibitor is still a question for debate. Phase III trial data in TNF-IR patients show comparable efficacy results across biologic agents and limited head-to-head studies have been published. Prospective registries offer a unique opportunity to observe the effectiveness (combined evaluation of efficacy and safety profile over time)  of these agents in a clinical setting. Our objectives is to evaluate if patients with rheumatoid arthritis (RA) treated with rituximab after failing a first anti-TNF agents (TNF-IR) have a different drug retention rate than patients similarly prescribed adalimumab, etanercept or infliximab.

Methods: Data from TNF-IR RA patients prescribed adalimumab (ADA), etanercept (ETA), infliximab (INF) or rituximab (RIT) as a second biologic agent on or after January 1st 2007 was extracted. Baseline demographics included age, disease duration, HAQ-DI, fatigue and pain visual analog scale evaluations (VAS), TJC, SJC, DAS 28 ESR and SDAI. Person-years of treatment were also compared across biologic agents. Five-year drug retention rates were estimated and compared using Kaplan-Meier survival estimates. Statistical analysis was performed using SAS version 9.3. RHUMADATA® is a clinical database and registry used in daily clinical practice at the IRM and CORQ.

Results: The data from 126 RA patients were extracted. No significant differences in baseline variables were observed between treatment groups. The 5 year retention rates of ADA, ETA, INF and RIT after failing second line anti-TNF agent were 28%, 27%, 13% and 66% with significant statistical differences (Log-rank  p<0.001). 

Conclusion: As a second line agent in TNF-IR patients rituximab demonstrate a better 5 year retention rate than the comparator agents. 

Disclosure:

L. Bessette,
None;

D. Choquette,
None;

D. Sauvageau,
None;

B. Haraoui,
None;

J. P. Pelletier,
None;

J. P. Raynauld,
None;

E. Villeneuve,
None;

L. Coupal,
None.

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