Effectiveness of a second biologic after failure of a non–tumor necrosis factor inhibitor as first biologic in rheumatoid arthritis
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Objective. In rheumatoid arthritis (RA), evidence regarding the effectiveness of a second biologic disease-modifying antirheumatic drug (bDMARD) in patients whose first-ever bDMARD was a non–tumor necrosis factor inhibitor (TNFi) bDMARD is limited. The objective of this study was therefore to assess the outcome of a second bDMARD (non-TNFi: rituximab [RTX], abatacept [ABA], or tocilizumab [TCZ], separately; and TNFi) after failure of a non-TNFi bDMARD as first bDMARD. Methods. We identified patients with RA from the 5 Nordic biologics registers who started treatment with a non-TNFi as first-ever bDMARD but switched to a second bDMARD. For the second bDMARD, we assessed drug survival (at 6 and 12 months) and primary response (at 6 months). Results. We included 620 patients starting a second bDMARD (ABA 86, RTX 40, TCZ 67, and TNFi 427) following failure of a first non-TNFi bDMARD. At 6 and 12 months after start of their second bDMARD, approximately 70% and 60%, respectively, remained on treatment, and at 6 months, less than one-third of patients were still on their second bDMARD and had reached low disease activity or remission according to the Disease Activity Score in 28 joints. For those patients whose second bMDARD was a TNFi, the corresponding proportion was slightly higher (40%). Conclusion. The drug survival and primary response of a second bDMARD in patients with RA switching due to failure of a non-TNFi bDMARD as first bDMARD is modest. Some patients may benefit from TNFi when used after failure of a non-TNFi as first bDMARD.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Journal of Rheumatology |
| Vol/bind | 48 |
| Udgave nummer | 10 |
| Sider (fra-til) | 1512-1518 |
| Antal sider | 7 |
| ISSN | 0315-162X |
| DOI | |
| Status | Udgivet - 2021 |
Bibliografisk note
Funding Information:
This study was partly funded by grants from Nord-Forsk and FOREUM. 1K. Chatzidionysiou, MD, PhD, Associate Professor, T. Frisell, PhD, Associate Professor, D. Di Giuseppe, PhD, K. Hellgren, MD, PhD, J. Askling, MD, PhD, Professor, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; 2M.L. Hetland, MD, PhD, Professor, B. Glintborg, MD, PhD, Associate Professor, DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, on behalf of the DANBIO Registry, Copenhagen, Denmark; 3D. Nordström, MD, PhD, Professor, R. Peltomaa, MD, PhD, N. Trokovic, MS, Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; 4K. Aaltonen, MD, PhD, Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland; 5E.K. Kristianslund, MD, PhD, T.K. Kvien, MD, PhD, Professor, S.A. Provan, MD, PhD, Professor, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; 6B. Gudbjornsson, MD, PhD, Professor, Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; 7G. Grondal, MD, PhD, Professor, Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; 8L. Dreyer, MD, PhD, Professor, Department of Rheumatology, Aalborg University Hospital, and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 9L.E. Kristensen, MD, PhD, Professor, T.S. Jørgensen, MD, PhD, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark; 10L.T. Jacobsson, MD, PhD, Professor, Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. KC has received consultancy fees from Eli Lilly, AbbVie, and Pfizer. MLH has received grant/research support from BMS, MSD, AbbVie, Roche, Novartis, Biogen, and Pfizer; consultancy fees from Eli Lilly; and speaker’s fees from Orion Pharma, Biogen, Pfizer, CellTrion, Merck, and Samsung Bioepis. DN has received consultancy fees from AbbVie, BMS, Celgene, MSD, Novartis, Pfizer, Roche, and UCB. BjG has received speaker fees from Novartis. TKK has received consulting fees, speaking fees, and/or honoraria from AbbVie, Amgen, Biogen, BMS, Celtrion, Egis, Eli Lilly, Evapharma, Ewopharma, Janssen, MSD, Mylan, Oktal Pharma, Orion Pharma, Pfizer, Roche, Sandoz, Sanofi, and UCB Pharma. LD has received grant/research support from BMS; consultancy fees from Janssen pharmaceuticals; and speaker’s fees from Eli Lilly, UCB, and MSD. LEK has received consulting fees, speaking fees and/or honoraria from AbbVie, Amgen, Biogen, BMS, Eli Lilly, Janssen, Novartis, Pfizer, Sanofi, and UCB Pharma. TSJ has received consulting fees and/or speaking fees from AbbVie, Pfizer, Roche, Novartis, UCB, Biogen, and Eli Lilly. JA (as the principal investigator) and the Karolinska Institutet have entered into agreements with the following companies mainly regarding the safety monitoring of b/tsDMARDs in rheumatology: AbbVie, BMS, MSD, Eli Lilly, Pfizer, Roche, Samsung Bioepis, Sanofi, and UCB. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. K. Chatzidionysiou, Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden. Email: aikaterini.chatzidionysiou@ki.se. Accepted for publication February 19, 2021.
Publisher Copyright:
© 2021 The Journal of Rheumatology.
ID: 288195084