Better Drug Survival of Non-TNFi Compared to TNFi Biologics after Non-TNFi Failure in RA Patients: A Single Center Experience

Konstantinos Thomas, Christos Koutsianas, Argyro Lazarini, Christina Tsalapaki, Chrisoula Hatzara, Anna Kandili, Katerina Antonatou and Dimitrios Vassilopoulos, University of Athens Medical School, Clinical Immunology and Rheumatology Unit, 2nd Department of Medicine and Laboratory, Athens, Greece

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Anti-TNF therapy and rheumatoid arthritis (RA), Biologics

Session Information

Date: Tuesday, November 10, 2015

Title: Rheumatoid Arthritis - Small Molecules, Biologics and Gene Therapy Poster III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

There
are sparse data in the literature regarding the drug survival of TNFi vs. non-TNFi
biologics in rheumatoid arthritis (RA) patients who have already failed non-TNFi
treatment in a real-life setting. We studied the drug survival of non-TNFi
versus TNFi biologics in RA patients after failure of the first non-TNFi
biologic in daily clinical practice.

Methods:

Data
were collected retrospectively in RA patients treated with different biologics
in our center from January 1, 2003 to June 1, 2015. Analyses were stratified by
the first type of biologic agent after the 1^st non-TNFi failure and
then by RF status, csDMARD and corticosteroid co-administration and previous TNFi use. Kaplan-Meier survival analysis and log-rank test of
equality pairwise over strata were performed.

Results:

Among
237 biologic treated RA patients, 40 patients with non-TNFi failure
(rituximab-RTX n=16, abatacept-ABA n=16, tocilizumab-TCZ n=8) were included; 28/40
(70%) had previously failed TNFi, 39/40 (97.5%) were women, 20/40 (50%) were RF
and/or anti-CCP+, their mean age was 61.8 ± 11.3 years with a mean follow-up of
27.2 ± 23.4 months (median 17.5). 70% of patients (28/40) were switched to a 2^nd
non-TNFi (TCZ n=17, RTX n=6, ABA n=5) and 30% (12/40) to an TNFi. The baseline
characteristics did not differ significantly between the 2 groups with the
exception of previous TNFi exposure [non-TNFi: 25/28 (89%) vs. TNFi: 3/12 (25%),
p<0.0001]. The mean estimated drug survival after switching to a 2^nd
non-TNFi was significantly longer (33.8 ± 5.8 months) compared to switching to
a TNFi (5.4 ± 1.1 months) (p<0.0001). The corresponding survival rates at 12
months were 74% vs 8.3% and at 24 months 53.8% vs 0%, respectively (p<0.0001).
This difference in survival maintained its statistical significance when the
groups were stratified according to RF positivity and csDMARD
co-administration. All 3 non-TNFi drug classes
(RTX, TCZ, ABA) had significantly better survival when compared to TNFi.

Conclusion:

In
this observational real life study, in RA patients who had failed the 1^st
non-TNFi, switching to a 2^nd non-anti-TNFi was associated with
better drug survival compared to switching to a TNFi, regardless of serological
status or csDMARD co-administration.

Disclosure: K. Thomas, None; C. Koutsianas, None; A. Lazarini, None; C. Tsalapaki, None; C. Hatzara, None; A. Kandili, None; K. Antonatou, None; D. Vassilopoulos, None.

To cite this abstract in AMA style:

Thomas K, Koutsianas C, Lazarini A, Tsalapaki C, Hatzara C, Kandili A, Antonatou K, Vassilopoulos D. Better Drug Survival of Non-TNFi Compared to TNFi Biologics after Non-TNFi Failure in RA Patients: A Single Center Experience [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/better-drug-survival-of-non-tnfi-compared-to-tnfi-biologics-after-non-tnfi-failure-in-ra-patients-a-single-center-experience/. Accessed .

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