ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2765

Long-Term Retention Rate of First Biologics in Patients of Age over 75 Years with Rheumatoid Arthritis in Japanese Clinical Practice: Results from the Multicenter Biologic Registry

Masatoshi Hayashi1, Toshihisa Kanamono2, Hiroyuki Matsubara3, Toshihisa Kojima4, Koji Funahashi5, Nobunori Takahashi4 and Naoki Ishiguro6, 1Department of Orhtopedic Surgery and Rheumatology, Nagano Red Cross Hospital, Nagano, Japan, 2Reumatology, Nagano Red Cross Hospital, Nagano, Japan, 3Department of Orthopedic Surgery and Rheumatology, Nagano Red Cross Hospital, Nagano, Japan, 4Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan, 5Nagoya University, Nagoya, Japan, 6Department of Orthopedic Suregery, Nagoya University Hospital, Nagoya, Japan

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: , ,

Session Information

Date: Tuesday, November 10, 2015

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

Session Type: ACR Poster Session C

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

Background/Purpose: The objective of this report was to clarify and compare the retention rate of first biologics used to treat elderly Japanese patients with rheumatoid arthritis (RA) in clinical practice.

Methods: A prospective analysis was performed on 197 patients of age over 75 years with RA who were followed up in our multicenter registry since its establishment. We assessed the age, sex, disease duration, Steinblocker’s Stage and Class, Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28ESR), past surgical history, complications, methotrexate use and dose, and corticosteroid use and dose as baseline characteristics, and compared cumulative survival and reasons for discontinuation among patients treated with TNF-inhibitors (TNF-i), abatacept, and tocilizumab.

Results: Of the 197 patients, 140 (71%) were treated with TNF-i, 48 (24%) with abatacept, and 9 (5%) with tocilizumab. Patients in the abatacept group were older and had worse Steinblocker’s Class, fewer complications, and lower methotrexate use than those in the TNF-i group; however, they had similar DAS28ESR at baseline (see table). As a result, the abatacept group was superior to the TNF-i group in terms of cumulative survival (p = 0.002, log-rank test).

Conclusion: In our cohort of patients of age over 75 years with RA, the abatacept group, despite a relatively worse RA presentation at baseline, had a better retention rate than the TNF-i group. This result should be valuable in managing active RA in elderly patients.

Table. Demographic and clinical characteristics of patients of age over 75 years with Rarheumatoid arthritis who received first biologic treatments.

Characteristics

total

TNF-i

abatacept

tocilizumab

P value†

Number (%)

197 (100)

140 (71)

48 (24)

9 (5)

Age, years

78.3 ± 3.2

78.0 ± 3.1

79.1 ± 3.4

78.4 ± 2.7

0.030*

Female, %

76

75

81

56

0.434

RA duration, years

11.0 ± 11.4

11.0 ± 11.1

12.7 ± 13.2

4.2 ± 4.4

0.781

Steinblocker’s Stage III or ‡W, %

62

65

59

33

0.585

Steinblocker’s Class 3 or 4, %

46

42

64

22

0.014*

DAS28ESR

5.42 ± 1.19

5.36 ± 1.20

5.36 ± 1.18

6.31 ± 0.79

0.928

Past operations, %

27

31

19

0

0.135

Complications, %

81

91

43

86

<0.001*

MTX use, %

59

68

36

75

<0.001*

MTX dose, mg/weeks

6.8 ± 2.1

6.9 ± 1.8

6.7 ± 3.2

6.0 ± 1.3

0.482

Oral corticosteroids use, %

60

66

49

57

0.068

PSL-equivalent dose, mg/day

3.0 ± 3.1

3.4 ± 3.2

2.2 ± 2.8

3.6 ± 3.5

0.059

AE as reason of discontinuations, no. (%)

42 (48)

39 (48)

2 (50)

1 (33)

1.000

Data are mean ± standard deviation. †P values are calculated between TNF-i and abatacept with suitable statistics. RA rheumatoid arthritis, TNF-i tumor necrosis factor inhibitor, DAS disease activity score, ESR erythrocyte sedimentation rate, MTX methotrexate, PSL prednisolone, AE adverse events.

Disclosure: M. Hayashi, None; T. Kanamono, None; H. Matsubara, None; T. Kojima, Takeda Pharma Corporation, 2,Janssen Pharmaceutical, 2,Astellas Pharma Corporation, 2,Mitsubishi Tanabe Pharma Corporation, 8,Takeda Pharma Corporation, 8,Eisai Pharma Corporation, 8; K. Funahashi, Abbvie Japan Co. Ltd, 8,Eisai Co. Ltd, 8,UCB Japan Co. Ltd, 8,Mitsubishi Tanabe Pharma Co., 8,Takeda pharmaceutical Co. Ltd, 8,Pfizer Co. Ltd, 8,Chugai Pharma Co. Ltd, 8,Janssen Pharma KK, 8,Bristol-Myers Squibb, 8; N. Takahashi, None; N. Ishiguro, Takeda, Mitsubishi-Tanabe, Astellas, Chugai, Abbott, Bristol-Myers Squibb, Eisai, Janssen, Kaken, Pfizer, 2,Takeda, Mitsubishi-Tanabe, Astellas, Chugai, Abbott, Bristol-Myers Squibb, Eisai, Janssen, Kaken, Pfizer, Taisho-Toyama, Otsuka, 8.

To cite this abstract in AMA style:

Hayashi M, Kanamono T, Matsubara H, Kojima T, Funahashi K, Takahashi N, Ishiguro N. Long-Term Retention Rate of First Biologics in Patients of Age over 75 Years with Rheumatoid Arthritis in Japanese Clinical Practice: Results from the Multicenter Biologic Registry [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/long-term-retention-rate-of-first-biologics-in-patients-of-age-over-75-years-with-rheumatoid-arthritis-in-japanese-clinical-practice-results-from-the-multicenter-biologic-registry/. Accessed .

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