ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2413

Similar Response Rates to Anti-Tumor Necrosis Factor and Non- Anti-Tumor Necrosis Factor Biologic Therapies in Ethnic Minority Patients at 6 Months

Gail S. Kerr1, Yusuf Yazici2, Christopher Swearingen3, Luis R. Espinoza4, Edward L. Treadwell5, Yvonne Sherrer6, Angelia Mosley-WIlliams7, Ignacio Garcia-Valladares8, Rodolfo Perez Alamino9, Sharon Dowell10, Mercedes Quinones11, Akgun Ince12, Theresa Lawrence Ford13, Chunqiao Luo14, Adrian Godoy10 and John Amatruda15, 1Rheumatology, Washington DC VAMC, Georgetown and Howard University, Washington, DC, 2Department of Medicine, Division of Rheumatology, New York University School of Medicine, New York, NY, 3Pediatrics and Biostatistics, University of Arkansas, Little Rock, AR, 4Medicine-Section of Rheum, LSU Medical Center, New Orleans, LA, 5Dept Medicine Div of Rheum, East Carolina University, Greenville, NC, 6Rheum/Immunology, Centre Rheum Immunol Arthritis, Fort Lauderdale, FL, 7Rheumatology, Detroit VAMC, Detroit, MI, 8Immunology and Rheumatology, Hospital General de Occidente, Zapopan, Jal., Mexico, 9internal Medicine, LSUHSC, New Orleans, LA, 10Division of Rheumatology, Howard University, Washington, DC, 11Division of Rheumatology, Howard University Hospital, Washington, DC, 12Arthitis Consultants Inc, St. Louis University, St. Louis, MO, 13North Georgia Rheumatology Group, PC, Lawrenceville, GA, 14University of Arkansas for Medical Sciences, Little Rock, AR, 15Rheumatology, Howard University, Washington, DC

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Rheumatoid Arthritis - Clinical Aspects (ACR): Impact of Various Interventions and Therapeutic Approaches

Session Type: Abstract Submissions (ACR)

Similar Response Rates to Anti-Tumor Necrosis Factor and Non- Anti-Tumor Necrosis Factor Biologic Therapies in Ethnic Minority Patients

Background/Purpose: Biologic therapies have expanded the treatment options and strategies for rheumatoid arthritis (RA). While anti-tumor necrosis factor (anti-TNF) biologic response rates are well established, in multi-ethnic populations, the response to anti-TNF and non- anti-TNF agents is unknown. Hence, we evaluated the response rates to RA biologic therapies in a diverse ethnic cohort

Methods: Ethnic Minority RA Consortium (EMRAC) patients with follow up data were evaluated. Comparisons of patient socio-demographic (age, gender, race, education, smoking), RA disease status (disease duration, RF, ACPA, nodules/erosions), DMARD use, and disease activity (RAPID3) were made between anti-TNF and non-anti-TNF therapies using chi-square test of categorical variables and Wilcoxon-Mann-Whitney test for continuous variables. A logistic regression analysis associating RAPID3 outcome (low/moderate disease vs severe disease) at last follow-up encounter with anti-TNF and non-anti-TNF therapies adjusting for age, disease duration, gender, smoking, race and baseline RAPID3 was performed

Results: EMRAC analysis of biologic responses in 350 subjects with an average followup of 8 months was performed (Table) More Caucasians received biologic therapies and anti-TNF use was most common. Anti-TNF patients were similar to non-anti-TNF patients in all demographic and clinical characteristics, including use of DMARD therapy. While, baseline RAPID3 was significantly higher in non-anti-TNF than anti-TNF patients, there was no significant difference in proportions of patients achieving RAPID3 outcome between biologic groups (P=0.969), adjusting for age, duration, gender, smoking, and baseline RAPID3.  Moreover, no differences between races were observed in achieving RAPID3 outcome (P=0.688, regression).

Conclusion: There is a similar prevalence of use and response to anti-TNF and non-anti-TNF biologic agents in ethnic minority RA patients in routine clinical care. Follow up analyses are needed to assess sustained clinical response and outcomes to the varied biologic armamentaria, inclusive of ethnic subsets.

 

Patient Characteristics of Biologic Use in EMRAC Cohort

Biologics

Anti-TNF

Other

P

N

 

276

74

 

Age (years)

52.0 (14.6)

53.9 (14.7)

0.366

Education (years)

14.7 (3.5)

14.8 (3.5)

0.862

Duration (years)

9.7 (7.8)

10.6 (8.5)

0.475

Drug Treatment (months)

7.9 (6.0)

7.5 (5.5)

0.654

ACPA

161.9 (93.9)

174.9 (104.2)

0.564

RF

337.2 (373.7)

436.7 (555.5)

0.903

Baseline RAPID3

11.8 (7.4)

15.4 (6.5)

<0.001

Female (N %)

230 (83.6%)

63 (85.1%)

0.755

Hx Smoking (N %)

66 (31.7%)

15 (36.6)

0.544

Hx Erosion (N %)

41 (21.7%)

12 (35.5%)

0.086

Hx Nodules (N %)

15 (8.5%)

5 (17.9%)

0.123

DMARD Use (N %)

212 (76.8%)

56 (75.7%)

0.838

Race

0.119

Caucasian

111 (46.4%)

37 (53.6%)

African-American

48 (20.1%)

12 (17.4%)

Hispanic

51 (21.3%)

18 (26.1%)

Other

29 (12.1%)

2 (2.9%)

Final RAPID3

0.432*

Low / Moderate

58 (28.3%)

8 (13.6%)

 

Severe

147 (71.7%)

51 (86.4%)

* Logistic Regression adjusting for Age, Duration, Race, Smoking and Baseline RAPID3

 

Disclosure:

G. S. Kerr,

Genentech and Biogen IDEC Inc.,

2,

Bristol-Myers Squibb,

2,

Pfizer Inc,

2;

Y. Yazici,

Genentech and Biogen IDEC Inc.,

2,

Pfizer Inc,

2,

Bristol-Myers Squibb,

2,

Abbvie,

5,

Bristol-Myers Squibb,

5,

Celgene,

5;

C. Swearingen,

Genentech and Biogen IDEC Inc.,

2,

Pfizer Inc,

2,

Bristol-Myers Squibb,

2;

L. R. Espinoza,

Genentech and Biogen IDEC Inc.,

2,

Pfizer,

2,

Bristol-Myers Squibb,

2;

E. L. Treadwell,

Genentech and Biogen IDEC Inc.,

2,

Pfizer,

2,

Bristol-Myers Squibb,

2;

Y. Sherrer,

Genentech and Biogen IDEC Inc.,

2,

Pfizer,

2,

Bristol-Myers Squibb,

2;

A. Mosley-WIlliams,

Genentech and Biogen IDEC Inc.,

2,

Pfizer Inc,

2,

Bristol-Myers Squibb,

2;

I. Garcia-Valladares,

Genentech and Biogen IDEC Inc.,

2,

Pfizer,

2,

Bristol-Myers Squibb,

2;

R. Perez Alamino,

Genentech and Biogen IDEC Inc.,

2,

Pfizer,

2,

Bristol-Myers Squibb,

2;

S. Dowell,

Genentech and Biogen IDEC Inc.,

2,

Pfizer,

2,

Bristol-Myers Squibb,

2;

M. Quinones,

Genentech and Biogen IDEC Inc.,

2,

Pfizer Inc,

2,

Bristol-Myers Squibb,

2;

A. Ince,

Genentech and Biogen IDEC Inc.,

2,

Pfizer Inc,

2,

Bristol-Myers Squibb,

2;

T. Lawrence Ford,

Genentech and Biogen IDEC Inc.,

2,

Pfizer Inc,

2,

Bristol-Myers Squibb,

2,

Human Genome Sciences, Inc.,

2,

Abbive,

2,

Eli Lilly and Company,

2,

Roche Pharmaceuticals,

2,

Bristol-Myers Squibb,

9,

Questcor,

8,

Abbvie,

8,

UCB,

8,

Pfizer Inc,

8,

Amgen,

8,

Takeda,

8,

Actelion Pharmaceuticals US,

8;

C. Luo,
None;

A. Godoy,
None;

J. Amatruda,
None.

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