ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1514

Drug Survival In Patients Receiving Golimumab Treatment 2010-2013. Results From The Swedish Rheumatology Quality Register

Saedis Saevarsdottir1, Michele Santacatterina2, Leszek Stawiarz3, Carl Turesson4, Helena Forsblad5, Lennart T.H. Jacobsson6 and Staffan Lindblad7, 1Rheumatology Unit, Dept. of Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden, 2Biostatistics Core Facility, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, 3Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, 4Section of Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden, 5Dept of Rheumatology & Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, 6Department of Rheumatology and Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, 7Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: , , ,

Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment: II

Session Type: Abstract Submissions (ACR)

Background/Purpose: Golimumab is a TNF inhibiting biological drug that was approved in Sweden in 2010 for the treatment of Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) and Ankylosing Spondylitis (AS). In observational studies, the 24-month adhesion to therapy of TNF inhibitors in bio-naïve patients has ranged from about 50-70% in RA, 55-70% in PsA and 65-70% in AS. The aim of the current study was to evaluate cumulative survival probability of golimumab in clinical practice for these patient groups, as well as in patients registered with other spondyloarthritidies (SpA).

Methods: Data were retrieved for all patients initiating golimumab treatment from 2010 until April 30th2013 from the nationwide Swedish Rheumatology Quality register (SRQ), which hosts the register on biological treatments, ARTIS (Anti Rheumatic Treatment in Sweden). Survival analysis (Kaplan Meier) was performed with right censoring and log-rank test of equality across strata.

Results: In total, 1681 patients had initiated golimumab treatment during the study period. Of those, 678 (40%) had RA, 364 (22%) had PsA, and 240 (14%) had AS, while 194 (12%) were registered as SpA and 205 (12%) had other diagnoses. The proportions of women in RA/PsA/AS/SpA patient groups were 80%/50%/28%/52%, respectively; and their median age at baseline was 58/50/45/43 years. In patients with RA/PsA/AS/SpA, the proportions receiving golimumab as the first biological treatment were 47%/45%/41%/37%; and the proportions receiving concurrent disease-modifying anti-rheumatic drugs (DMARDs) were 70%/58%/22%/38%.

Table 1. Cumulative survival probability (% (N)) of golimumab treatment for the four main diagnoses, stratified by previous exposure to biological treatment.

 

Diagnosis

Number of previous biologicals

Baseline

6

12

18

24

RA

Bio-naive

100 (318)

78 (206)

65 (138)

59 (111)

56 (77)

 

1-2

100 (263)

74 (162)

60 (97)

54 (65)

52 (46)

 

3+

100 (97)

66 (56)

45 (33)

42 (24)

32 (14)

 

 

 

 

 

 

 

PsA

Bio-naive

100 (163)

83 (107)

69 (70)

59 (47)

56 (31)

 

1-2

100 (150)

79 (89)

62 (51)

55 (33)

51 (20)

 

3+

100 (51)

71 (32)

59 (21)

53 (15)

53 (7)

 

 

 

 

 

 

 

AS

Bio-naive

100 (98)

81 (66)

77 (47)

68 (32)

65 (14)

 

1-2

100 (118)

80 (79)

70 (54)

59 (31)

57 (22)

 

3+

100 (24)

74 (16)

45 (9)

40 (7)

40 (6)

 

 

 

 

 

 

 

SpA

Bio-naive

100 (72)

83 (46)

73 (33)

60 (19)

60 (15)

 

1-2

100 (94)

76 (61)

61 (36)

51 (24)

49 (15)

 

3+

100 (28)

61 (13)

55 (8)

47 (4)

47 (2)

____________________________________________________________________________________

Cumulative survival probability of golimumab treatment is shown in Table 1, stratified by previous exposure to biological treatment. In RA patients, there was a statistically significant difference in survival probability between bio-naïve patients and those patients who had received 1-2 or 3+ biological drugs before golimumab (p=0.0018), a similar trend was observed in patients with AS (p=0.069), but interestingly, not in patients with PsoA (p=0.6). The number of individuals who had received 3+ biological drugs before golimumab was limited in all patient groups.

Conclusion: In this large nationwide rheumatology register, drug survival in patients receiving golimumab treatment was generally higher in bio-naïve patients compared to patients previously treated with biological drugs. The 24-month adhesion rates in clinical practice appear to be comparable to other TNF inhibitors, whereas further studies are necessary to evaluate the long term performance of golimumab.

Disclosure:

S. Saevarsdottir,
None;

M. Santacatterina,
None;

L. Stawiarz,
None;

C. Turesson,

Abbvie, BMS, Janssen, MSD, Pfizer, Roche, UCB. ,

5;

H. Forsblad,
None;

L. T. H. Jacobsson,

Pfizer ,

2,

Pfizer ,

5,

UCB,

5,

Abbvie ,

5;

S. Lindblad,
None.

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