Retention rate of a second line with a biologic DMARD after failure of a first-line therapy with abatacept, tocilizumab, or rituximab: results from the Italian GISEA registry

Sebastiani, Marco; Venerito, Vincenzo; Bugatti, Silvia; Bazzani, Chiara; Biggioggero, Martina; Petricca, Luca; Foti, Rosario; Bortoluzzi, Alessandra; Balduzzi, Silvia; Visalli, Elisa; Frediani, Bruno; Manfredi, Andreina; Gremese, Elisa; Favalli, Ennio Giulio; Iannone, Florenzo; Ferraccioli, Gianfranco; Lapadula, Giovanni

doi:10.1007/s10067-021-05734-3

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…In a longitudinal study in the USA, discontinuation rates for second-line treatment were lower with TNFi agents than with non-TNFi b/tsDMARDs (hazard ratio 0.68) (Ramiro et al, 2015); in contrast, in a German database study, drug survival of second-line treatment was longer with non-TNFi bDMARDs than with TNFi agents (295 vs. 264 days; p = 0.02) (Wilke et al, 2017). Moreover, according to a recent analysis of the Italian GISEA registry (Sebastiani et al, 2021), RA patients who had discontinued first-line treatment with rituximab, abatacept, or tocilizumab, had higher 2-year retention rates for second-line treatment, or when they received another non-TNFi b/ tsDMARD, than when they received a TNFi agent (63.5% vs. 33.4%; p < 0.001); multivariate analysis indicated that the mechanism of action was the only predictor for maintenance in therapy (Sebastiani et al, 2021). This analysis is limited by its observational and retrospective design, the small number of eligible patients in the BIOBADASER database at the time of analysis, and the inclusion of data over only 2 years.…”

Section: Discussionmentioning

confidence: 99%

Retention of golimumab treatment following discontinuation of non‐TNF inhibitors in patients with inflammatory rheumatic diseases: An analysis of the Spanish BIOBADASER registry

Pombo‐Suárez

Sánchez-Piedra

Ruiz‐Montesino

et al. 2021

Musculoskeletal Care

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Section: Discussionmentioning

confidence: 99%

Retention of golimumab treatment following discontinuation of non‐TNF inhibitors in patients with inflammatory rheumatic diseases: An analysis of the Spanish BIOBADASER registry

Pombo‐Suárez

Sánchez-Piedra

Ruiz‐Montesino

et al. 2021

Musculoskeletal Care

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“…At 6 months, less than one-third of recipients of a second non-TNFi agent remained on treatment and had low disease activity/ remission, compared with 40% of those who received a TNFi. In contrast, an analysis of the Italian GISEA registry found that among 278 RA patients who were switched to another bDMARD after failure of a first-line non-TNFi bDMARD (rituximab, abatacept or tocilizumab), the 2-years retention rate was higher among patients who received another non-TNFi as second-line therapy compared with those who received a TNFi (63.5% versus 33.4%, p < 0.001) [13]. Three other studies in RA have also described inconsistent results [10][11][12].…”

Section: Discussionmentioning

confidence: 92%

“…Whilst the use of non-TNFi bDMARDs or tsDMARDs after discontinuation of TNFi has been shown to be effective [5][6][7][8][9], data on the opposite scenario (i.e., use of TNFi after discontinuation of non-TNFi bDMARDs or tsDMARDs) are scarce. Available studies have involved patients with RA and reported retention rates for periods of up to 2 years after switching from a non-TNFi bDMARD to a TNFi [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Four-years retention rate of golimumab administered after discontinuation of non-TNF inhibitors in patients with inflammatory rheumatic diseases

et al. 2023

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Background In patients with rheumatic diseases, the use of biological (b) or targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs) after discontinuation of tumor necrosis factor inhibitors (TNFi) is known to be effective. However, data on the use of TNFi after discontinuation of non-TNFi bDMARDs or tsDMARDs (non-TNFi) are scarce. This study assessed the 4-years golimumab retention in patients with rheumatic diseases when used after discontinuation of non-TNFi. Methods Adults with rheumatoid arthritis (RA; n = 72), psoriatic arthritis (PsA; n = 30) or axial spondyloarthritis (axSpA; n = 23) who initiated golimumab after discontinuation of non-TNFi from the Spanish registry of biological drugs (BIOBADASER) were analyzed retrospectively. The retention rate (drug survival or persistence) of golimumab up to 4 years was evaluated. Results The golimumab retention rate was 60.7% (51.4–68.8) at year 1, 45.9% (36.0–55.2) at year 2, 39.9% (29.8–49.7) at year 3 and 33.4% (23.0–44.2) at year 4. Retention rates did not differ significantly whether golimumab was used as second, third, or fourth/subsequent line of therapy (p log-rank = 0.462). Golimumab retention rates were higher in axSpA or PsA patients than in RA patients (p log-rank = 0.002). When golimumab was administered as third or fourth/subsequent line, the 4-years retention rate after discontinuation of non-TNFi was similar to that after discontinuation of TNFi. Conclusion In patients who discontinued non-TNFi, most of whom received golimumab as third/subsequent line of therapy, one-third of patients remained on golimumab at year 4. Retention rates were higher in patients with axSpA and PsA than in those with RA.

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“…Like for younger patients ( 20 , 21 ), an insufficient clinical response remains the first cause of drug discontinuation in this specific population ( 22 ). Approximately half of patients showed a secondary loss of drug response.…”

Section: Discussionmentioning

confidence: 99%

Retention rate of biologic and targeted synthetic anti-rheumatic drugs in elderly rheumatoid arthritis patients: data from GISEA registry

Manfredi,

Fornaro,

Bazzani

et al. 2024

Front. Med.

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ObjectivesAn increased number of elderly individuals affected by rheumatoid arthritis (RA) has been reported, including both patients with RA onset in advanced age and patients aged with the disease. In this registry-based study, we aimed to analyze the retention rate and cause of discontinuation of biologic (b) and targeted synthetic (ts)-disease-modifying anti-rheumatic drugs (DMARDs) in RA patients over 65 year old.MethodsRA patients enrolled in the Italian GISEA registry and starting a b- or a ts-DMARD over 65 years of age were included. Demographic, clinical, serologic, and therapeutic features were collected.ResultsA total of 1,221 elderly RA patients were analyzed (mean age 71.6 ± 5.2 years). RA was diagnosed before 65 years in 72.5% of cases, a 60.6% of patients experienced a previous b- or ts-DMARD. In patients older than 65 initiating a new b- or ts-DMARDS, tumor necrosis factor alpha inhibitors (TNFi) were prescribed in 29.6% of patients, abatacept in 24.8%, anti-interleukin 6 receptor antagonists (anti-IL6R) in 16.3%, Janus kinases inhibitors (JAKi) in 24.9%, and rituximab in 4.4%. The main causes of discontinuation were primary or secondary inadequate responses (66.1%). The median retention rate for all treatments was 181.3 weeks. A statistically higher retention rate was observed for abatacept when compared to TNFi (p = 0.02), JAKi (p < 0.001), and anti-IL6R (p < 0.001), and for TNFi vs. JAKi (p = 0.013).ConclusionWe described, in a real-life setting, elderly RA patients treated with a biologic or a ts-DMARD in Italy. Loss of efficacy was the main cause of discontinuation, and the DMARD safety profile suggests that age does not contraindicate their use. Our study reinforced that the control of disease activity is mandatory.

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Retention rate of a second line with a biologic DMARD after failure of a first-line therapy with abatacept, tocilizumab, or rituximab: results from the Italian GISEA registry

Cited by 5 publications

References 33 publications

Retention of golimumab treatment following discontinuation of non‐TNF inhibitors in patients with inflammatory rheumatic diseases: An analysis of the Spanish BIOBADASER registry

Retention of golimumab treatment following discontinuation of non‐TNF inhibitors in patients with inflammatory rheumatic diseases: An analysis of the Spanish BIOBADASER registry

Four-years retention rate of golimumab administered after discontinuation of non-TNF inhibitors in patients with inflammatory rheumatic diseases

Retention rate of biologic and targeted synthetic anti-rheumatic drugs in elderly rheumatoid arthritis patients: data from GISEA registry

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