The Effectiveness of Intravenous Golimumab Administered Directly After Infliximab in Rheumatoid Arthritis Patients

Abstract

PurposeFor patients with rheumatoid arthritis (RA) who do not respond or lose response to anti-tumor necrosis factor (TNF) biologics, switching to a different anti-TNF can be an effective means to manage symptoms and disease progression. This study examined the utilization and effectiveness of intravenous golimumab within a real-world population of patients with RA switching directly from infliximab, a potent anti-TNF.MethodsPatient charts (n = 113) were collected from five US-based rheumatology practices. Patient demographics, treatment characteristics, infliximab and intravenous golimumab utilization data, and Clinical Disease Activity Index (CDAI), Patient Global Assessment (PtGA), Physician Global Assessment (PhGA), and Routine Assessment of Patient Index Data (RAPID3) scores were extracted from charts. The effectiveness of intravenous golimumab was assessed by comparing disease activity status pre- and post-initiation of intravenous golimumab therapy.FindingsSignificant decreases in patient disease activity were observed following treatment with intravenous golimumab. Mean CDAI and PhGA scores significantly decreased, and a significantly increased proportion of the population exhibited low disease activity or remission in the post intravenous golimumab period (p < 0.05). Limited changes were observed through the RAPID3 and PtGA.ConclusionsFindings from this study indicate that intravenous golimumab is effective in managing RA in a population of patients switching directly from infliximab (mean last dose 7.4 mg/kg).

Improvement in disease activity among patients with rheumatoid arthritis who switched from intravenous infliximab to intravenous golimumab in the ACR RISE registry

“…A previous report indicates that, except for the patient global assessment, CDAI and RAPID3 components are not highly correlated [ 21 ]. The discordance of group-level data in this study is consistent with a previous IV-infliximab-to-IV-golimumab switch study [ 22 ] and is likely due to the exclusively patient-reported components that compose the RAPID3 score that may be conflated by other factors including anxiety, depression, and pain catastrophizing [ 17 , 23 , 24 ]. The CDAI, on the other hand, comprises a physician-reported scale plus a patient global score and total tender and swollen joint counts [ 16 ]; evidence points to tender and swollen joint counts as being the main CDAI score contributors [ 25 ].…”