Two‐year persistence of golimumab as second‐line biologic agent in rheumatoid arthritis as compared to other subcutaneous tumor necrosis factor inhibitors: real‐life data from the LORHEN registry

Two‐year persistence of golimumab as second‐line biologic agent in rheumatoid arthritis as compared to other subcutaneous tumor necrosis factor inhibitors: real‐life data from the LORHEN registry

Objectives To evaluate the 2‐year retention rate of golimumab compared with etanercept and adalimumab as second‐line biologic agent in rheumatoid arthritis (RA) patients who failed a previous tumor necrosis factor inhibitor (TNFi). Methods Data on RA patients treated with a second‐line subcutaneous...

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Published in:International journal of rheumatic diseases Vol. 21; no. 2; pp. 422 - 430
Main Authors: Favalli, Ennio G., Sinigaglia, Luigi, Becciolini, Andrea, Grosso, Vittorio, Gorla, Roberto, Bazzani, Chiara, Atzeni, Fabiola, Sarzi Puttini, Pier C., Fusaro, Enrico, Pellerito, Raffaele, Caporali, Roberto
Format: Journal Article
Language:English
Published: England Wiley Subscription Services, Inc 01-02-2018
Subjects:
anti‐TNF
biologic agents
drug survival
Etanercept
golimumab
Monoclonal antibodies
Necrosis
Retention
Rheumatoid arthritis
second line
Survival
Survival analysis
TNF inhibitors
treatment
Tumor necrosis factor
Tumor necrosis factor-TNF
treatment
biologic agents
second line
drug survival
rheumatoid arthritis
golimumab
anti-TNF
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Summary:Objectives To evaluate the 2‐year retention rate of golimumab compared with etanercept and adalimumab as second‐line biologic agent in rheumatoid arthritis (RA) patients who failed a previous tumor necrosis factor inhibitor (TNFi). Methods Data on RA patients treated with a second‐line subcutaneous TNFi were extracted from a multicentric Italian cohort (the LORHEN registry). The analysis was limited to etanercept, adalimumab and golimumab in the period when all were available in Italy (since October 2010). The 2‐year retention rate was calculated by Kaplan–Meier method and the comparative risk for discontinuation among individual TNFi was compared by a stratified log‐rank test. Results One hundred and ninety‐five RA patients treated with etanercept (n = 76), adalimumab (n = 68) or golimumab (n = 51) were included in the analysis. The 2‐year retention rate (40% with a median time‐on‐drug of 12.9 months in the whole population) was significantly lower for adalimumab (31.2%, P = 0.018) and numerically lower for etanercept (39.8%, P = 0.068) compared with golimumab (53.4%) because of a higher discontinuation rate due to adverse events (P = 0.042 and P = 0.038 versus golimumab, respectively). Drug survival was greater in concomitant synthetic disease modifying anti‐rheumatic drug (sDMARD) users (44.2%) compared with TNFi monotherapy (22.5%, P = 0.036). No difference was found in survival analysis according to first‐line TNFi reason for discontinuation and pattern of TNFi switch (antibody‐receptor, antibody‐antibody or receptor‐antibody). Conclusions Our real‐life data confirmed switching to a second TNFi as a good option for treating first‐line TNFi failures in RA, especially in combination with sDMARDs. Second‐line golimumab showed an overall better 2‐year drug survival compared with adalimumab and etanercept.
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ISSN:1756-1841
1756-185X
DOI:10.1111/1756-185X.13199