Change Over Time in the Pattern of Clinical Response to First-line Biologic Drugs in Patients with Rheumatoid Arthritis: Observational Data in a Real-life Setting

Favalli, Ennio Giulio; Becciolini, Andrea; Meroni, Pier Luigi

doi:10.3899/jrheum.161045

Cited by 4 publications

(2 citation statements)

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“…In both studies, the earlier use of TNFi in RA correlated with improved outcomes 11 , 22 . An Italian real-life clinical study covering the period from 1999 to 2015, which included a limited number of RA patients, showed an increasing tendency for earlier introduction of bDMARDs during the disease course, even in those with moderate disease activity and less severity 12 . With regards to PsA patients, a previous study reported a trend to lower disease duration in PsA patients starting bDMARDs during the period 1999–2008 2 .…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, despite all these changes, few studies have assessed how the use patterns of these compounds in rheumatic patients have changed since bDMARDs have become available. Most studies that have analyzed changes over time in the use patterns of bDMARDs have focused almost exclusively on rheumatoid arthritis (RA) patients 11 , 12 . However, studies analyzing these temporary changes in the use of bDMARDs in psoriatic arthritis (PsA) 13 or ankylosing spondylitis (AS) remain very scarce.…”

Section: Introductionmentioning

confidence: 99%

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Changes in the use patterns of bDMARDs in patients with rheumatic diseases over the past 13 years

Sánchez-Piedra

Sueiro-Delgado

García‐González

et al. 2021

Sci Rep

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The better understanding of the safety of biologic DMARDs (bDMARDs), as well as the emergence of new bDMARDs against different therapeutic targets and biosimilars have likely influenced the use patterns of these compounds over time. The aim of this study is to assess changes in demographic characteristics, disease activity and treatment patterns in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS) who started a first- or second-line biologic between 2007 and mid-2020. Patients diagnosed with RA, PsA or AS included in the BIOBADASER registry from January 2007 to July 2020 were included. According to the start date of a first- or second-line biologic therapy, patients were stratified into four time periods: 2007–2009; 2010–2013; 2014–2017; 2018–2020 and analyzed cross-sectionally in each period. Demographic and clinical variables, as well as the type of biologic used, were assessed. Generalized linear models were applied to study the evolution of the variables of interest over time periods, the diagnosis, and the interactions between them. A total of 4543 patients initiated a first biologic during the entire time frame of the study. Over the four time periods, disease evolution at the time of biologic initiation (p < 0.001), disease activity (p < 0.001), retention rate (p < 0.001) and the use of tumor necrosis factor inhibitors as a first-line treatment (p < 0.001) showed a significant tendency to decrease. Conversely, comorbidities, as assessed by the Charlson index (p < 0.001), and the percentage of patients using bDMARDs in monotherapy (p < 0.001), and corticosteroids (p < 0.001) tended to increase over time. Over the entire period of the study's analysis, 3289 patients started a second biologic. The following trends were observed: decreased DAS28 at switching (p < 0.001), lower retention rates (p = 0.004), and incremental changes to the therapeutic target between the first and second biologic (p < 0.001). From 2007 until now rheumatic patients who started a biologic were older, exhibited less clinical activity, presented more comorbidities, and switched to a different biologic more frequently and earlier.

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