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Pombo-Suarez M, Sanchez-Piedra C, Garcia-Magallón B, Pérez-Gómez A, Manrique-Arija S, Martín-Doménech R, Colazo M, Campos C, Campos J, Del Pino-Montes J, Arteaga MJ, Cea-Calvo L, Díaz-González F, Gómez-Reino JJ. Factors associated with long-term retention of treatment with golimumab in rheumatoid arthritis, axial spondyloarthritis, and psoriatic arthritis: an analysis of the Spanish BIOBADASER registry. Clin Rheumatol 2021; 40:3979-3988. [PMID: 33907904 DOI: 10.1007/s10067-021-05742-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Retention of biological treatment provides a marker of drug effectiveness and patient satisfaction. Retention of golimumab was high in clinical trial extensions and real-world studies up to 5 years in patients with immune-mediated rheumatic diseases. OBJECTIVE To assess the probability of real-world long-term retention of treatment with golimumab up to 7 years after treatment initiation. METHODS This retrospective noninterventional study involved analysis of the Spanish biological drugs registry, BIOBADASER. Adults who had ever received golimumab for rheumatoid arthritis (RA), axial spondyloarthritis (SpA), or psoriatic arthritis (PsA), and had initiated it > 6 months before the analysis date, were included. RESULTS Among 685 patients (28.5% RA, 42.9% SpA, 28.6% PsA), the overall probability of retention of golimumab treatment since initiation was 71.7% (95% confidence interval 68.1-74.9) at year 1, 60.5% (56.5-64.2%) at year 2, 55.6% (51.5-59.5%) at year 3, 50.6% (46.2-54.8%) at year 4, 45.1% (40.1-50.0%) at year 5, 44.2% (39.0-49.3) at year 6, and 39.5% (32.8-46.2) at year 7. Retention was greater in patients with axial SpA or PsA versus RA (p < 0.001) and when golimumab was used as first-line treatment versus third or later lines (p < 0.001). Factors associated with greater golimumab retention in Cox regression included use as first-line biological therapy, having axial SpA or PsA rather than RA, and concomitant methotrexate therapy. Steroids were associated with lower retention. CONCLUSION In this real-world study of RA, axial SpA, and PsA patients, the retention rate of golimumab was 39.5% at year 7. Key Points • Retention of biological treatment provides a marker of drug effectiveness and patient satisfaction. • This real-world study of 685 patients with rheumatoid arthritis (RA), axial spondyloarthritis (SpA), or psoriatic arthritis (PsA) showed that golimumab treatment had a retention rate up to 39.5% at year 7. • Greater golimumab retention was associated with use as first-line biological therapy, having axial SpA or PsA rather than RA, and concomitant methotrexate therapy.
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Affiliation(s)
- Manuel Pombo-Suarez
- Department of Rheumatology, Hospital Universitario de Santiago de Compostela, Rúa da Choupana, s/n, 15706 Santiago de Compostela, A Coruña, Spain.
| | | | | | - Ana Pérez-Gómez
- Department of Rheumatology, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | | | | | - María Colazo
- Department of Rheumatology, Hospital Universitario de Burgos, Burgos, Spain
| | - Cristina Campos
- Department of Rheumatology, Hospital General Universitario de Valencia, Valencia, Spain
| | - José Campos
- Department of Rheumatology, Hospital Puerta de Hierro, Madrid, Spain
| | - Javier Del Pino-Montes
- Department of Rheumatology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | | | - Federico Díaz-González
- Department of Rheumatology, Hospital Universitario de Canarias, Sta Cruz de Tenerife, Spain
| | - Juan J Gómez-Reino
- Department of Rheumatology, Hospital Universitario de Santiago de Compostela, Rúa da Choupana, s/n, 15706 Santiago de Compostela, A Coruña, Spain
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Yu CL, Yang CH, Chi CC. Drug Survival of Biologics in Treating Ankylosing Spondylitis: A Systematic Review and Meta-analysis of Real-World Evidence. BioDrugs 2021; 34:669-679. [PMID: 32946076 DOI: 10.1007/s40259-020-00442-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The last decade has witnessed the increasing use of biologics for the treatment of ankylosing spondylitis (AS). Drug survival is an outcome incorporating real-world effectiveness and safety. However, the drug survival of biologics in treating AS is unclear. OBJECTIVE The aim was to assess the drug survival of biologics (tumor necrosis factor inhibitors and anti-interleukin-17 monoclonal antibodies) in treating AS. METHODS We conducted a systematic review and meta-analysis and searched the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase databases up to 13th May 2020. Studies that analyzed the drug survival of biologics for AS and reported the respective annual data for each biologic for at least 1 year were included. Two authors independently screened and selected studies and assessed their risk of bias. A third author was available for arbitrating discrepancies. The Newcastle-Ottawa Scale was employed to evaluate the risk of bias of included studies. We conducted a random-effects model meta-analysis to obtain pooled drug survival from year 1 to 5. We performed subgroup analyses for biologic-naïve patients, first-line versus second- and third-line biologics, discontinuation due to loss of effectiveness and adverse effects, and high-quality studies. RESULTS We included 39 studies with 32,493 patients. The drug survival decreased from 76% at year 1 to 51% at year 5 for etanercept, from 75 to 51% for adalimumab, from 76 to 53% for infliximab, from 72 to 49% for golimumab, and from 63 to 57% for certolizumab pegol. The drug survival rate for secukinumab was 0.77 (95% confidence interval 0.64‒0.90) at year 1. Subgroup analyses on biologic-naïve patients and discontinuation due to adverse effects found no differences in the drug survival of various biologics except for a lower drug survival of infliximab in biologic-naïve patients. The drug survival for first-line biologics was higher than for second- and third-line biologics. CONCLUSION To the best of our knowledge, this study is the first systematic review and meta-analysis on the drug survival of biological therapies for AS patients. The drug survival of all biologics in treating AS appeared comparable, but is higher in first-line biologics than second- and third-line biologics. To date there are scarce data on the drug survival of newly available biologics, for example, anti-interleukin-17 biologics. PROSPERO REGISTRATION NO CRD42018114204.
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Affiliation(s)
- Chia-Ling Yu
- Department of Pharmacy, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Chung-Han Yang
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, 5, Fuxing St, Guishan Dist, Taoyuan, 33305, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Rahman P, Baer P, Keystone E, Choquette D, Thorne C, Haraoui B, Chow A, Faraawi R, Olszynski W, Kelsall J, Rampakakis E, Lehman AJ, Nantel F. Long-term effectiveness and safety of infliximab, golimumab and golimumab-IV in rheumatoid arthritis patients from a Canadian prospective observational registry. BMC Rheumatol 2020; 4:46. [PMID: 32968710 PMCID: PMC7501619 DOI: 10.1186/s41927-020-00145-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/03/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Long-term clinical registries are essential tools to evaluate new therapies in a patient population that differs from those in randomized clinical trials. The objectives are to describe the profile of rheumatoid arthritis (RA) patients treated with anti-TNF agents in Canadian routine care. METHODS RA patients eligible for treatment with Infliximab (IFX), golimumab (GLM) or intravenous golimumab (GLM-IV) as per their respective Canadian product monographs were enrolled into the BioTRAC registry between 2002 and 2017. Study visits occurred at baseline and every 6 months thereafter. Effectiveness was assessed by changes in disease activity. Safety was evaluated by the incidence of adverse events (AEs) and drug survival. RESULTS Of the 890 IFX-, 530 GLM- and 157 GLM-IV-treated patients, the proportion of females ranged from 77.0-86.6%, the mean ages from 55.8-57.7 and the mean disease duration from 6.5-8.6 years. A significant decrease in baseline disease duration and disease activity parameters (DAS, TJC, SJC, HAQ, AM stiffness, MDGA, PtGA, CRP, ESR) was observed over time. Treatment with IFX, GLM- and GLM-IV significantly improved all disease parameters over time. The incidence of AEs was 105, 113 and 82.6 /100 PYs and the incidence of SAEs was 11.7, 11.2 and 4.68 /100 PYs for IFX, GLM- and GLM-IV-treated patients, respectively. CONCLUSION Differences in baseline characteristics between patients treated with an anti-TNFs over time shows the evolution of treatment modalities over time. All treatments significantly reduced disease activity and improved functionality in a similar fashion. The incidence of adverse events was consistent with the safety profiles of IFX and GLM. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00741793 (Retrospectively registered on August 26, 2008).
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Affiliation(s)
| | | | | | | | | | - Boulos Haraoui
- Institut de Rhumatologie de Montréal, Montreal, QC Canada
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Acurcio FDA, Guerra Junior AA, da Silva MRR, Pereira RG, Godman B, Bennie M, Nedjar H, Rahme E. Comparative persistence of anti-tumor necrosis factor therapy in ankylosing spondylitis patients: a multicenter international study. Curr Med Res Opin 2020; 36:677-686. [PMID: 31990224 DOI: 10.1080/03007995.2020.1722945] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective: To evaluate persistence on conventional DMARDs (cDMARDs) and anti-TNF therapies, and to identify potential determinants of discontinuation among individuals with ankylosing spondylitis (AS) living in Brazil and Quebec, Canada.Methods: We conducted a cohort study of AS patients using health administrative data (2010-2015). One-year and 2-year persistence rates were assessed. Cox regression was used to identify potential determinants of therapy discontinuation.Results: One-year persistence was less likely in Brazil for both anti-TNF and cDMARDs (Brazil: 62.1 and 30.7%, Quebec: 66.9 and 67.0%). The 2-year persistence rates were lower for both anti-TNF and cDMARD, but remained higher in Quebec (Brazil: 47.9 and 18.1%, Quebec: 51.5 and 53.5%). In multivariate Cox regression analysis, age, sex and comorbidities were associated with persistence in both countries. In Quebec, persistence did not differ between rural and urban regions or with socioeconomic status. While in Brazil, patients in regions with higher Human Development Index and those in cities with lower Gini index were less likely to discontinue therapy.Conclusions: Canadian AS patients were more likely to persist on therapy compared to Brazilian patients, although rates were lower at 2 years in both countries. Socioeconomic disparity in persistence was found in Brazil, but not in Quebec.
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Affiliation(s)
- Francisco de Assis Acurcio
- Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais (UFMG), Minas Gerais, Brazil
- SUS Collaborating Centre for Technology Assessment and Excellence in Health (CCATES), School of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil
- Department of Social and Preventive Medicine, Post-graduated Program of Public Health, School of Medicine, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Augusto Afonso Guerra Junior
- Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais (UFMG), Minas Gerais, Brazil
- SUS Collaborating Centre for Technology Assessment and Excellence in Health (CCATES), School of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Michael Ruberson Ribeiro da Silva
- Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais (UFMG), Minas Gerais, Brazil
- SUS Collaborating Centre for Technology Assessment and Excellence in Health (CCATES), School of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Ramon Gonçalves Pereira
- Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais (UFMG), Minas Gerais, Brazil
- SUS Collaborating Centre for Technology Assessment and Excellence in Health (CCATES), School of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Division of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Health Economics Centre, Liverpool University Management School, Liverpool, United Kingdom
| | - Marion Bennie
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Hacene Nedjar
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Elham Rahme
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Medicine, Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada
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