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Abstract Number: 102

Real-World Utilization, Patient Characteristics and Persistency of Certolizumab Pegol Vs Other Anti-TNFs for the Treatment of Rheumatoid Arthritis in the United Kingdom

Frances Humby1, Stephen Kelly1, Angela V. Bedenbaugh2, Nawab Qizilbash3,4, Jochen Dunkel5, Belén SanJose3, Ignacio Mendez3, Jennifer Timoshanko6 and Jeyanesh Tambiah2, 1Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom, 2UCB Pharma, Smyrna, GA, 3OXON Epidemiology, London, United Kingdom, 4Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom, 5UCB Pharma, Monheim, Germany, 6UCB Pharma, Slough, United Kingdom

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Adalimumab, anti-TNF therapy, certolizumab pegol, etanercept and rheumatoid arthritis (RA)

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Session Information

Session Title: Health Services Research

Session Type: Abstract Submissions (ACR)

Background/Purpose

Several anti-TNFs are currently approved in Europe for RA treatment including certolizumab pegol (CZP), adalimumab (ADA), etanercept (ETN), golimumab and infliximab. UK NICE guidance recommends CZP as a first-line biologic therapy for patients (pts) with RA, in conjunction with a Pt Access Scheme that provides CZP free of charge for the first 12 weeks (wks). The objective was to assess real-world CZP, and other subcutaneous anti-TNFs (ADA or ETN), RA pt characteristics and treatment utilization in the UK.

Methods

A descriptive, retrospective, observational chart analysis was conducted in 4 UK rheumatology clinics. Medical data were collected over 52(-6/+9) wks for biologic-naïve pts initiating an anti-TNF (N=187); visit schedule was not prescribed therefore exact visit timing varied across pts. Data are reported for CZP pts and those receiving Other Anti-TNFs. Treatment persistency was assessed up to Wk52 using Kaplan-Meier estimates with pts censored at treatment discontinuation (ie. stop first anti-TNF treatment and switch to another/stop anti-TNFs) and excluding reinitiators (ie. pts with a gap in therapy returning to treatment within follow-up period).

Results

Baseline (BL) data were available for 110 CZP pts and 77 pts receiving Other Anti-TNFs (Figure 1A). At initiation, 14.5% (16/110) and 20.8% (16/77) pts received CZP and Other Anti-TNF monotherapy, respectively. Of those receiving combination therapy, 79.8% (75/94) CZP and 78.7% (48/61) Other Anti-TNF pts received concomitant MTX.

Due to the retrospective nature of data collection, not every pt had all data available; data were collected for 110, 108, 82 CZP pts and 77, 74, 50 Other Anti-TNF pts over 12, 24, 52 wks, respectively. Treatment persistency was 95.5%, 82.6%, 71.8% for CZP and 90.9%, 73.5%, and 65.0% for Other Anti-TNF pts at 12, 24, 52 wks, respectively (all lower bounds above 60% for corresponding CIs) (Figure 1B). Mean treatment persistency was 46.3 (95% CI: 43.2–49.4) and 43.1 (95% CI: 38.5–47.7) wks for CZP and Other Anti-TNF pts, respectively. Of pts initiating CZP, 2.7% switched therapy to another anti-TNF at any time during follow-up (n=3; 1 pt each 0-11, 12-24, 25-52 wks). Similarly, 6.5% of Other Anti-TNF pts switched to another anti-TNF (n=5; 4 pts before Wk12, 1 pt 12-24 wks). Compared to CZP pts, the risk of discontinuation in the Other Anti-TNF group was 37.4% greater (Hazard Ratio=1.374; 0.820-2.302). The majority of discontinuations occurred within the first 24 wks for both groups.

Conclusion

In this descriptive study, BL demographics/disease activity for pts treated with anti-TNFs in the UK were broadly similar between groups. Treatment persistency in this real-world observational study was also similar between CZP and Other Anti-TNFs in anti-TNF naïve pts. Interpretation of data is limited due to general caveats inherent to retrospective analyses.


Disclosure:

F. Humby,
None;

S. Kelly,

Abbvie, MSD, Roche, UCB Pharma,

8;

A. V. Bedenbaugh,

UCB Pharma,

3,

UCB Pharma,

1;

N. Qizilbash,

OXON Epidemiology,

3;

J. Dunkel,

UCB Pharma,

3;

B. SanJose,

OXON Epidemiology,

3;

I. Mendez,

Employee OXON Epidemiology,

3;

J. Timoshanko,

UCB Pharma,

3;

J. Tambiah,

UCB Pharma,

3,

UCB Pharma,

1.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/real-world-utilization-patient-characteristics-and-persistency-of-certolizumab-pegol-vs-other-anti-tnfs-for-the-treatment-of-rheumatoid-arthritis-in-the-united-kingdom/

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