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Abstract Number: 752

Drug Retention and Discontinuation Reasons Between Seven Biologics in Patients with Takayasu Arteritis

Corrado Campochiaro1, Alessandro Tomelleri 2, Silvia Sartorelli 3, Giulio Cavalli 2, De Luca Giacomo 4, Elena Baldissera 2 and Lorenzo Dagna 2, 1Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy, 2Unit of Immunology, Rheumatology, Allergy and Rare Diseases. IRCCS San Raffaele Hospital. Vita-Salute San Raffaele University., Milan, Italy, 3Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy, 4Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy., Milan, Italy

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Biologic agents, Takayasu arteritis, tocilizumab and large vessel vasculitis, Tumor necrosis factor (TNF)

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Session Information

Date: Sunday, November 10, 2019

Session Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster I: Takayasu's Arteritis & Polymyalgia Rheumatica

Session Type: Poster Session (Sunday)

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

Background/Purpose: Takayasu’s arteritis (TA) is a large vessel vasculitis affecting mainly young women. Biologic agents are currently use to treat refractory TA patients but no data are available on drug retention rate (DRR) of biologic disease-modifying anti-rheumatic drugs (bDMARDs) TA patients. We retrospectively investigated DRR and reasons for discontinuation of seven bDMARDs in TA patients in a real-world setting.

Methods: TA patients followed-up in our Centre fulfilling the 1990 ACR criteria and treated with ≥1 bDMARD were selected. Data about disease duration, number of bDMARDs, reasons for bDMARDs discontinuation, concomitant conventional synthetic (cs)DMARDs were collected. Survival curves were examined by the Kaplan-Meier method and compared using a stratified log-rank test. 24-month DRR was calculated. Hazard ratio (HR) for concomitant csDMARDs and for previous bDMARDs was evaluated. A comparative sub-analysis between anti-TNFα drugs and tocilizumab was performed.

Results: We identified 50 patients and 86 bDMARD-courses. Patients characteristics are summerized in Table 1.No significant differences were observed in age and disease duration between the seven groups (data not shown). Infliximab was the most frequent first-line bDMARD (78.6%). At bDMARDs initiation, all patients were on prednisone (mean dose, 13.5±10.3 mg/day) and 85.2% on concomitant csDMARD therapy. 43% of treatment courses were stopped by 24 months. Golimumab had the highest DRR (71.4%), followed by infliximab (69%), adalimumab (56.3%), abatacept (50%), tocilizumab (41.1%), anakinra (0%) and rituximab (0%), p=0.016. Concomitant csDMARDs therapy showed positive effects on DRR (HR=2.87, 95% CI=1.19-6.92, p=0.019). Anti-TNFα drugs had significantly higher DRR compared to tocilizumab (67.2% vs 41.1%, p=0.028), see Figure 1. Even in these subgroups, csDMARDs showed positive effects on DRR (HR=3.79, 95% CI=1.49-9.6, p=0.005).

Conclusion: Anti-TNFα agents had the highest DRR overall and a higher DRR in a head-to-head comparison with tocilizumab. Concomitant csDMARDs had a significant positive effect on bDMARDs DRR.


Table 1 Taka


Figure 1 Taka


Disclosure: C. Campochiaro, GSK, 8, GSK, SOBI, Pfizer, 5, 8, Pfizer, 8, SOBI, 5; A. Tomelleri, None; S. Sartorelli, None; G. Cavalli, SOBI, Novartis, Pfizer, 5, 8; D. Giacomo, GSK, 8, Pfitzer, 8, SOBI, 5, SOBI, Novartis, SOBI, Pfizer, 5, 8; E. Baldissera, Sobi, 8, Sanofi, 5, Roche, 8, Pfizer, 8, Novartis, 8, Abbvie, 8, Alfa-sigma, 8; L. Dagna, Abbvie, Amgen, Biogen, Bristol-Myers Squibb, Celltrion, Novartis, Pfizer, Sanofi-Genzyme, and SOBI., 5, 8.

To cite this abstract in AMA style:

Campochiaro C, Tomelleri A, Sartorelli S, Cavalli G, Giacomo D, Baldissera E, Dagna L. Drug Retention and Discontinuation Reasons Between Seven Biologics in Patients with Takayasu Arteritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/drug-retention-and-discontinuation-reasons-between-seven-biologics-in-patients-with-takayasu-arteritis/. Accessed May 17, 2022.
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