Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Previous studies have shown that, when sustained good clinical response has been achieved with a biologic therapy, traditional disease-modifying anti-rheumatic drugs (DMARDs) and other treatments can be reduced or discontinued. The aim of this analysis was to assess the discontinuation of concomitant treatment and DMARD tapering in rheumatoid arthritis (RA) patients treated with golimumab (GLM) in Canadian routine clinical practice.
Methods: BioTRAC is an ongoing, prospective registry of patients initiating treatment for RA, ankylosing spondylitis, psoriatic arthritis with infliximab or GLM as first biologics or after having been treated with a biologic for <6 months. Patients with RA treated with GLM who were enrolled between 2010 and 2014 were included in this analysis. DMARD, steroid and NSAID discontinuation were defined as no use of any drugs in these categories. Time to treatment discontinuation or tapering was assessed both with descriptive statistics and the Kaplan Meier estimator of the survival function.
Results: 273 RA patients treated with GLM (mean dose = 50 mg s.c. monthly) were included in the analysis; 72.2% were female, mean (SD) age was 57.4 (13.5) years and disease duration was 8.1 (8.6) years. Mean (SD) disease parameters at baseline were: DAS28 = 5.1 (1.7), CDAI = 27.8 (15.9), SJC28 = 7.9 (5.9), TJC28 = 8.9 (7.0), HAQ-DI = 1.3 (0.7), MDGA (0-10 NRS) = 5.5 (2.2), PtGA (mm VAS) = 54.6 (27.9). At baseline, 74.7% were taking concomitant DMARDs, 30.8% were on NSAIDS, and 21.2% on corticosteroid. Mean (SD) available follow-up was 13.8 (9.4) months. Upon treatment with GLM, 11.8% of the patients on a DMARD at baseline discontinued DMARD treatment after a mean (SD) of 15.3 (10.0) months. Furthermore, 56.9% and 86.7% of patients completely discontinued steroid and NSAID treatment after a mean (SD) follow-up of 8.9 (5.4) months and 6.2 (1.3) months, respectively. DMARD dose tapering was documented for 32.4% of patients on DMARDs after a mean (SD) follow-up of 11.2 (8.9) months.
Conclusion: The results of this Canadian longitudinal observational study have shown that treatment with GLM was associated with discontinuation of concomitant DMARD, steroid, and NSAID treatment as well as DMARD tapering in RA patients. The long-term benefits of this practice for patients have to be determined.
To cite this abstract in AMA style:Baer P, Bell M, Haraoui B, Bessette L, Kelsall J, Sheriff M, Rampakakis E, Psaradellis E, Nantel F, Lehman AJ, Osborne B, Tkaczyk C, Maslova K. Concomitant Treatment Use during Treatment with Golimumab in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/concomitant-treatment-use-during-treatment-with-golimumab-in-patients-with-rheumatoid-arthritis/. Accessed October 28, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/concomitant-treatment-use-during-treatment-with-golimumab-in-patients-with-rheumatoid-arthritis/