Session Information
Date: Sunday, November 13, 2016
Title: Rheumatoid Arthritis – Small Molecules, Biologics and Gene Therapy - Poster I
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Evaluate the reason of exchange of biologic therapy in patients with rheumatoid arthritis and describe the frequency of remission or low activity, according to the disease activity score (DAS28).
Methods: A retrospective study including patients with rheumatoid arthritis, according to the ACR/EULAR 2010 criteria, age over 18 years, who were using any biologic therapy. We collected demographic and therapy data, disease duration, presence of rheumatoid factor and bone erosion on X-rays, reasons for exchange of biologic therapy: primary failure, secondary failure or adverse events and assessment of disease activity, according DAS28.
Results: 94 patients were included, 40% had moderate activity disease and 60% had high activity disease at the beginning of biologic therapy. Anti-TNF was the first choice therapy in 85 patients: 37% were using adalimumab, 36% etanercept, 13% infliximab, and 4% golimumab. Abatacept was the first choice therapy in 5% of the patients and tocilizumab in 4% of the patients. The mean follow-up was 8 years. In this period, we found 103 exchanges of biologic therapy. The reason for switching was primary failure in 26% of the patients, secondary failure in 43% and occurrence of adverse events in 31%. There was no need of switching in all 5 patients who started abatacept as first choice therapy. At the end of follow-up 28% achieved remission of disease (p <0.05) and 18% achieved low activity disease (p <0.05). 54% remained in moderate or high activity (p <0.05). At this time, 59% were using anti-TNF (27% Adalimumab, 19% Etanercept, 3% Infliximab, 7% certolizumab and 2% golimumab), 19% abatacept, 9% Tocilizumab and 14% Rituximab. Table – Reasons for switching biologic agent in 94 RA patients in a mean follow-up of 8 years.
|
ADA |
ETA |
INFL |
GOL |
CERT |
ABATA |
TOCI |
RITUX |
Total |
|
|
Primary failure |
4 |
9 |
3 |
3 |
0 |
5 |
1 |
2 |
27 |
|
Secondary failure |
15 |
16 |
8 |
3 |
0 |
0 |
1 |
1 |
44 |
|
Adverse effects |
12 |
11 |
4 |
1 |
0 |
0 |
4 |
0 |
32 |
|
Total |
31 |
36 |
15 |
7 |
0 |
5 |
6 |
3 |
103 |
ADA: Adalimumab; ETA: Etanercept; INFL: Infliximab; GOL: Golimumab; CERT: Certolizumab; ABATA: Abatacept; TOCI: Tocilizumab; RITUX: Rituximab; RA: rheumatoid arthritis
Conclusion: In this population there were 103 exchanges of biologic agents. The average of follow-up was 8 years. At the end of follow-up, we found 28% remission and 18% of low disease activity, but 54% of patients remained in high or moderate activity.
To cite this abstract in AMA style:
Souza B, Valim J, Chaer F, Guimarães F, Lima V. Switching Biologic Therapy in a Population of Rheumatoid Arthritis Patients [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/switching-biologic-therapy-in-a-population-of-rheumatoid-arthritis-patients/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/switching-biologic-therapy-in-a-population-of-rheumatoid-arthritis-patients/