Session Type: Abstract Submissions (ACR)
Background/Purpose: The order of use of biologic agents after failing a TNF inhibitor is still a question for debate. Phase III trial data in TNF-IR patients show comparable efficacy results across biologic agents and limited head-to-head studies have been published. Prospective registries offer a unique opportunity to observe the effectiveness (combined evaluation of efficacy and safety profile over time) of these agents in a clinical setting. Our objectives is to evaluate if patients with rheumatoid arthritis (RA) treated with rituximab after failing a first anti-TNF agents (TNF-IR) have a different drug retention rate than patients similarly prescribed adalimumab, etanercept or infliximab.
Methods: Data from TNF-IR RA patients prescribed adalimumab (ADA), etanercept (ETA), infliximab (INF) or rituximab (RIT) as a second biologic agent on or after January 1st 2007 was extracted. Baseline demographics included age, disease duration, HAQ-DI, fatigue and pain visual analog scale evaluations (VAS), TJC, SJC, DAS 28 ESR and SDAI. Person-years of treatment were also compared across biologic agents. Five-year drug retention rates were estimated and compared using Kaplan-Meier survival estimates. Statistical analysis was performed using SAS version 9.3. RHUMADATA® is a clinical database and registry used in daily clinical practice at the IRM and CORQ.
Results: The data from 126 RA patients were extracted. No significant differences in baseline variables were observed between treatment groups. The 5 year retention rates of ADA, ETA, INF and RIT after failing second line anti-TNF agent were 28%, 27%, 13% and 66% with significant statistical differences (Log-rank p<0.001).
Conclusion: As a second line agent in TNF-IR patients rituximab demonstrate a better 5 year retention rate than the comparator agents.
J. P. Pelletier,
J. P. Raynauld,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/use-of-rituximab-as-second-line-biologic-agent-compared-with-adalimumab-etanercept-and-infliximab-in-patients-with-rheumatoid-arthritis-a-report-from-the-rhumadata-clinical-database-and-regist/