ACR Meeting Abstracts

ACR Meeting Abstracts

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Abstract Number: 456

Factors Influencing Choice of Rituximab Versus an Alternative Tumor Necrosis Factor Inhibitor Following Tumor Necrosis Factor Inhibitor Failure in Patients with Rheumatoid Arthritis: Sub-Analysis of a Global, Observational Comparative Effectiveness Study

Axel Finckh1, Jacques-Eric Gottenberg2, Chiedzo Mpofu3, William G. Bensen4, Andrea Rubbert-Roth5, Fedra Irazoque6, Victor Martínez Taboada7, Carol Chung8, Lykke Hinsch-Gylvin3, Clodoveo Ferri9 and Paul Emery10, 1Department of Internal Medicine, University Hospital of Geneva, Geneva, Switzerland, 2Strasbourg University Hospital, Strasbourg, France, 3F Hoffmann-La Roche Ltd, Basel, Switzerland, 4Department of Medicine, Division of Rheumatology, Clinical Professor, McMaster University, Hamilton, ON, Canada, 5Internal Medicine I, University of Cologne, Cologne, Germany, 6Servicio de Reumatología, Hospital Angeles Mocel, Mexico City, Mexico, 7Rheumatology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain, 8Genentech Inc., South San Francisco, CA, 9Department of Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy, 10Division of Rheumatic & Musculoskeletal Disease, University of Leeds, Leeds, United Kingdom

Meeting: ACR/ARHP Annual Meeting 2012

Keywords:

Session Information

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

Session Type: Abstract Submissions (ACR)

Background/Purpose: SWITCH-RA is a global, observational study evaluating the effectiveness of switching to an alternative TNFi or rituximab (RTX) following initial TNFi failure in patients with RA. The study also assessed the reasons for discontinuation of initial TNFi therapy and factors that drive choice of RTX vs alternative TNFi as subsequent therapy.

Methods: Reasons for initial TNFi discontinuation and rationale for selection of subsequent therapy were recorded. The association between various factors and choice of RTX or alternative TNFi as second biologic were analyzed using logistic regression with a stepwise method for variable selection.

Results: A total of 1107 enrolled patients (mean age 55.5 yrs; mean disease duration 8.3 yrs) were analyzed. Reasons for discontinuing initial TNFi were: lack of efficacy (n=824 [74%]); intolerance (n=264 [24%]); other (n=19 [2%]). In all, 602 (54%) received RTX and 505 (46%) an alternative TNFi as second biologic. Factors associated with choice of RTX or alternative TNFi are shown in the Figure.

Factors most clearly associated with selection of RTX were generally associated with treatment characteristics related to the safety profile (no lymphoma risk, low infection risk, and good long-term tolerance after infusion) and frequency of administration. Factors most clearly associated with selection of an alternative TNFi were associated with treatment (route of administration, rapidity of action, short administration duration) and patient (treatment being compatible with patient’s professional life) characteristics.

Conclusion: Lack of efficacy was the main reason for discontinuation of an initial TNFi. Factors associated with selection of RTX over an alternative TNFi tended to be associated with treatment characteristics related to the safety profile and frequency of administration, while those associated with selection of an alternative TNFi were associated with administration and patient characteristics.

Disclosure:

A. Finckh,

Roche, Pfizer, BMS,

2,

Roche, BMS, Pfizer,

5;

J. E. Gottenberg,

Roche, Pfizer, MSD, Abbott,

5;

C. Mpofu,

F Hoffmann-La Roche Ltd,

3;

W. G. Bensen,

Abbott, Amgen, AstraZeneca, BMS, Merck-Schering, Janssen, Lilly, Novartis, Pfizer and Wyeth, Proctor and Gamble, Roche, Sanofi-Aventis, Servier, UCB, Warner Chilcott,

2,

Abbott, Amgen, AstraZeneca, BMS, Merck-Schering, Janssen, Lilly, Novartis, Pfizer and Wyeth, Proctor and Gamble, Roche, Sanofi-Aventis, Servier, UCB, Warner Chilcott,

5,

Abbott, Amgen, AstraZeneca, BMS, Merck-Schering, Janssen, Lilly, Novartis, Pfizer and Wyeth, Proctor and Gamble, Roche, Sanofi-Aventis, Servier, UCB, Warner Chilcott,

8;

A. Rubbert-Roth,

Roche, Pfizer,

2,

Roche, Chugai, Abbott, Pfizer, UCB, MSD,

5,

Roche, UCB, Chugai. MSD,

6,

Roche, UCB, Chugai, MSD,

8;

F. Irazoque,

Pfizer, Roche, Janssen,

5;

V. Martínez Taboada,

Schering-Plough, Wyeth-Pharma, Roche,

2,

UCB-Pharma, Bristol Myers Squibb, Roche, Cellerix, Pfizer,

5;

C. Chung,

Genentech, Inc (full time),

3;

L. Hinsch-Gylvin,

F Hoffmann-La Roche Ltd,

3;

C. Ferri,
None;

P. Emery,

Pfizer, Merck, Abbott, BMS, Roche, UCB,

5.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/factors-influencing-choice-of-rituximab-versus-an-alternative-tumor-necrosis-factor-inhibitor-following-tumor-necrosis-factor-inhibitor-failure-in-patients-with-rheumatoid-arthritis-sub-analysis-of-a/