Concomitant Treatment Use during Treatment with Golimumab in Patients with Rheumatoid Arthritis

Philip Baer¹, Mary Bell², Boulos Haraoui³, Louis Bessette⁴, John Kelsall⁵, Maqbool Sheriff⁶, Emmanouil Rampakakis⁷, Eliofotisti Psaradellis⁸, Francois Nantel⁹, Allen J Lehman¹⁰, Brendan Osborne¹¹, Cathy Tkaczyk¹¹ and Karina Maslova¹⁰, ¹Independent Rheumatology Practice, Scarborough, ON, Canada, ²University of Toronto, Toronto, ON, Canada, ³University of Montreal, Montreal, QC, Canada, ⁴Rheumatology, CHUL de Quebec, Quebec, QC, Canada, ⁵Mary Pack Arthritis Centre, Vancouver, Vancouver, BC, Canada, ⁶Nanaimo Regional General Hospital, Nanaimo, BC, Canada, ⁷JSS Medical Research, St-Laurent, QC, Canada, ⁸JSS Medical Research, Montreal, QC, Canada, ⁹19 Green belt Dr, Janssen Inc., Toronto, ON, Canada, ¹⁰Janssen Inc., Toronto, ON, Canada, ¹¹Medical Affairs, Janssen Inc., Toronto, ON, Canada

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: anti-TNF therapy

Session Information

Date: Sunday, November 13, 2016

Session Title: Rheumatoid Arthritis – Small Molecules, Biologics and Gene Therapy - Poster I

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.

Disclosure: P. Baer, Janssen Inc., 5; M. Bell, Paid Consultant of Janssen Inc., Canada, 5; B. Haraoui, Janssen Inc., 5; L. Bessette, Janssen Inc., 5; J. Kelsall, Janssen Inc., 5; M. Sheriff, Janssen Inc., 5; E. Rampakakis, employee of JSS Medical Research, 3; E. Psaradellis, employee of JSS Medical Research, 3; F. Nantel, Employee of Janssen Inc., 3; A. J. Lehman, Employee of Janssen Inc., 3; B. Osborne, Employee of Janssen Inc., 3; C. Tkaczyk, Employee of Janssen Inc., 3; K. Maslova, Employee of Janssen Inc., 3.

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 January 17, 2021.

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