ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1614

Monotherapy with Abatacept, Rituximab or Tocilizumab Is Not Associated with a Significantly Lower Long Term Retention Than Combination with Synthetic DMARD: Long-Term Registry Data in 4498 Real-Life Patients with Rheumatoid Arthritis

Jacques-Eric Gottenberg1, Jacques Morel2, Arnaud Constantin3, Thomas Bardin4, Alain G. Cantagrel5, Bernard Combe6, Maxime Dougados7, Rene-Marc Flipo8, Alain Saraux9, Thierry Schaeverbeke10, Jean Sibilia11, Martin Soubrier12, Olivier Vittecoq13, Elodie Perrodeau14, Philippe Ravaud15, Xavier Mariette16 and on behalf of the French Society of Rheumatology and of all the investigators participating to the AIR, ORA and REGATE registries, 1Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France, 2Rheumatology, Department of Rheumatology, Montpellier University Hospital, Montpellier, France, 3Rheumatology, CHU Purpan - Hopital Pierre-Paul Riquet, Toulouse, France, 4Clinique de Rhumatologie, Hopital Lariboisiere, Paris Cedex 10, France, 5Rheumatology, Centre Hospitalier Universitaire, Toulouse Purpan, Toulouse, France, 6Département Rhumatologie, Hôpital Lapeyronie, Montpellier, France, 7Rheumatology, Paris Descartes University, Paris, France, 8Rheumatology, University Hospital, Lille, France, 9Rheumatology, Brest University Hospital, Brest, France, 10Rheumatology, CHU Bordeaux, Bordeaux, France, 11Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France, 12Rheumatology, Department of Rheumatology, CHU Gabriel Montpied, Clermont-Ferrand, France, 13Rheumatology, Rouen University Hospital &INSERM U905, Rouen, France, 14Epidemiology, Hopital Hotel Dieu, Paris Descartes University, Paris, France, 15Epidemiologist, PARIS, France, 16Rheumatology, Rheumatology department, Bicetre Hospital, Paris-Sud University, Le Kremlin Bicetre, France

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , , ,

Session Information

Date: Monday, November 14, 2016

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

Session Type: ACR Poster Session B

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

Background/Purpose: Data are very limited concerning the association between cotreatment with a conventional synthetic DMARD (csDMARD) and long term retention of abatacept (ABA), rituximab (RTX) and tocilizumab (TCZ) in real life.

Methods: This was a pre-specified sub-group analysis of a multicenter open-label observational study of patients with RA according to 1987 ACR criteria who initiated RTX, ABA, or TCZ and were enrolled in 3 French Society of Rheumatology prospective registries (AIR for rituximab, ORA for abatacept, and REGATE for tocilizumab). We used a propensity-score approach to adjust for differences in observed factors that might affect both treatment assignment and outcome.

Results: Data on concomitant treatment were available in 4469 out of 4498 patients (99.6%). 34.9, 34.3 and 40.2% of patients respectively treated with ABA, RTX and TCZ, initiated their biologic in monotherapy. 79.5% of patients with a csDMARD received methotrexate. 3507 patients had a follow-up at 24 months for a total follow-up of 18898 patient-years (RTX: 10545; ABA: 4912; TCZ: 3441). – Effect of concomitant csDMARD on the effectiveness of each drug Drug retention without failure of RTX at 2 years was 67.8[65.2; 70.4]% in patients treated in combination with a csDMARD and 65.1 [61.5;68.8]% in monotherapy, HR of discontinuation 0.89 [0.76;1.05], p= 0.21. Drug retention without failure of RTX at 5 years was 50.1[47.4; 53.0]% in combination and 45.3 [41.5;49.4]% in monotherapy, HR of discontinuation of 0.88 [0.77;1.0], p= 0.08. Drug retention without failure of ABA at 2 years was 42.6[38.9; 46.7]% in patients treated in combination and 36.7 [31.9;42.2]% in monotherapy, HR of discontinuation 0.86 [0.73;1.01], p= 0.08. Drug retention without failure of ABA at 5 years was 22.8[19.7; 26.4]% in combination and 18.7 [15;23.5]% in monotherapy, HR of discontinuation of 0.87 [0.75;1.01], p= 0.07. Drug retention without failure of TCZ at 2 years was 66.1 [62.9; 69.6]% in patients treated in combination and 60.9 [56.8;65.4]% in monotherapy, HR of discontinuation 0.82 [0.66;1.02], p= 0.09. – Effect of concomitant csDMARD on the comparative effectiveness between ABA, RTX and TCZ At 2 years, drug retention without failure among patients treated in combination with a csDMARD was significantly greater with RTX and TCZ than ABA (hazard ratio 1.85 [95% CI: 1.52;2.26], and 1.83 [95% CI: 1.39;2·42], respectively), with no difference between RTX and TCZ. At 2 years, drug retention without failure among patients treated in monotherapy was significantly greater with RTX and TCZ than ABA (HR 2.29 [95% CI: 1.62;3.25], and 1.84 [95% CI: 1.15;2·96], respectively), with no difference between RTX and TCZ. At 5 years, drug retention without failure among patients treated in combination was significantly greater with RTX than ABA (HR 1.94 [95% CI: 1.64;2·29], and it was the same for patients treated in monotherapy (HR 2.31 [95% CI: 1.22;2·42]).

Conclusion: In real life patients, monotherapy with abatacept, rituximab or tocilizumab is not associated with a lower long term retention than combination with synthetic DMARD.

Disclosure: J. E. Gottenberg, Abbvie, BMS, Gsk, Janssen, Lilly, MSD, Pfizer, Roche, UCB, 5; J. Morel, None; A. Constantin, None; T. Bardin, None; A. G. Cantagrel, None; B. Combe, None; M. Dougados, Pfizer, AbbVie, Celgene, Eli Lilly, Novartis, Roche, and Sanofi-Aventis, 5,Pfizer, AbbVie, UCB, Merck, 8; R. M. Flipo, None; A. Saraux, None; T. Schaeverbeke, None; J. Sibilia, None; M. Soubrier, None; O. Vittecoq, None; E. Perrodeau, None; P. Ravaud, None; X. Mariette, None.

To cite this abstract in AMA style:

Gottenberg JE, Morel J, Constantin A, Bardin T, Cantagrel AG, Combe B, Dougados M, Flipo RM, Saraux A, Schaeverbeke T, Sibilia J, Soubrier M, Vittecoq O, Perrodeau E, Ravaud P, Mariette X. Monotherapy with Abatacept, Rituximab or Tocilizumab Is Not Associated with a Significantly Lower Long Term Retention Than Combination with Synthetic DMARD: Long-Term Registry Data in 4498 Real-Life Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/monotherapy-with-abatacept-rituximab-or-tocilizumab-is-not-associated-with-a-significantly-lower-long-term-retention-than-combination-with-synthetic-dmard-long-term-registry-data-in-4498-real-life-p/. Accessed .

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