ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2486

Real-World Outcomes Associated with Triple Therapy Vs. TNFi Combo Therapy: Results from the Corrona Registry

Jeffrey R. Curtis1, J. Lynn Palmer2, George W. Reed3, Jeffrey Greenberg4, Dimitrios A. Pappas5, Leslie R Harrold6 and Joel Kremer4, 1University of Alabama at Birmingham, Birmingham, AL, 2Corrona Research Foundation, Albany, NY, 3UMass Medical School, Worcester, MA, 4Corrona LLC, Waltham, MA, 5Columbia University, New York, NY, 6University of Massachusetts Medical School, Worcester, MA

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: combination therapies, Janus kinase (JAK), methotrexate (MTX), registry and rheumatoid arthritis (RA)

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Tuesday, October 23, 2018

Session Title: Rheumatoid Arthritis – Diagnosis, Manifestations, and Outcomes Poster III: Complications of Therapy, Outcomes, and Measures

Session Type: ACR Poster Session C

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

Background/Purpose: Despite several randomized controlled trials showing comparable clinical outcomes with triple therapy (Triple; MTX, SSZ, HCQ) versus combination therapy with MTX+TNFi (TNFi Combo), the real-world experience comparing these two strategies may differ.

 

Methods: We identified new users of Triple vs. TNFi Combo amongst RA patients in the Corrona registry. Initiation of these therapies could have been simultaneous or sequential, but patients had to receive all therapies simultaneously and could not have ever received Triple or TNFi Combo treatment previously. Patients must have had moderate/high disease activity (CDAI >10) at baseline and have >=1 follow-up visit.

Treatment failure was defined as starting/adding a new biologic/JAKi, csDMARD, or discontinuation of any of the medications in Triple or TNFi Combo exposures. Patients were censored if they attained low disease activity (CDAI< 10). Propensity score (PS) matching (1:3, and 1:1 as part of a sensitivity analysis) was used to balance exposure groups (8-1 digit Greedy Match), with caliper widening if required for higher order matches. Treatment failure was evaluated using KM curves. Cox models were used to control for residual imbalance in baseline factors and account for clustering of the matched PS pairs. An additional sensitivity analysis evaluated adjusted treatment failure in the entire unmatched sample, controlling for baseline factors and excluding patients in the non-overlapping tails of the PS.

 

Results: A total of 2156 TNFi Combo and 105 Triple patients were eligible for analysis. Before PS matching, numerous factors were imbalanced between the two groups, with Triple patients being older (mean age: 62 vs. 56yrs), having longer RA disease duration (9 vs. 6yrs), and a higher proportion with history of malignancy, diabetes, and serious infections. They also had lower baseline disease activity (mean Triple: 21.2 vs. TNFi Combo: 26.6).

After 1:3 PS matching (n=103 in Triple, n=309 in TNFi Combo in each group), balance was improved but some residual differences remained. Treatment failure was more likely in the Triple group (Figure). After multivariable adjustment, treatment failure was more likely in the Triple group compared to the TNFi combo group (adjusted hazard ratio [aHR]=1.38, 95% CI 1.02-1.88). Results from both sensitivity analyses (n=2240 patients in entire sample, n=204 in matched sample) were similar (HR=1.45, 95% CI 1.10 to 1.92; aHR=1.64, 95% CI=1.12-2.38 matched, respectively).

Conclusion: Based on real world evidence from a large U.S. RA registry, use of Triple is uncommon, and outcomes associated with Triple are less favorable compared to combination therapy with TNFi+MTX.

 

Figure: Treatment Failure associated with Triple Therapy (n=103) versus Combination TNFi+MTX (n=309)

Product-Limit Survival Curves with Number of Subjects at Risk

 


Disclosure: J. R. Curtis, AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Radius, Roche/Genentech, UCB, 2,AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Radius, Roche/Genentech, UCB, 5; J. L. Palmer, Corrona LLC, 1, 3; G. W. Reed, Corrona, 1, 3; J. Greenberg, Corrona LLC, 1,Corrona LLC, 3,Eli Lilly, Genentech, Janssen, Pfizer Inc, 5; D. A. Pappas, Corrona, LLC, 3,Novartis, 9; L. R. Harrold, Corrona, LLC, 1,Pfizer, Inc., 2,Roche, Bristol-Myers Squibb, 5,Corrona, LLC, University of Massachusetts Medical School, 3; J. Kremer, Corrona, LLC, 1,AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly and Company, Genentech, GlaxoSmithKline, Pfizer, Regeneron and Sanofi, 5.

To cite this abstract in AMA style:

Curtis JR, Palmer JL, Reed GW, Greenberg J, Pappas DA, Harrold LR, Kremer J. Real-World Outcomes Associated with Triple Therapy Vs. TNFi Combo Therapy: Results from the Corrona Registry [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/real-world-outcomes-associated-with-triple-therapy-vs-tnfi-combo-therapy-results-from-the-corrona-registry/. Accessed January 27, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/real-world-outcomes-associated-with-triple-therapy-vs-tnfi-combo-therapy-results-from-the-corrona-registry/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.