Long-term results of treatment of rheumatoid arthritis with adalimumab in the national ATTRA registry
Authors:
K. Pavelka 1; L. Nekvindová 2; Z. Křístková 2
Authors‘ workplace:
Revmatologický ústav, Praha
1; Institut biostatistiky a analýz, Brno
2
Published in:
Čes. Revmatol., 26, 2018, No. 4, p. 153-161.
Category:
Original article
Overview
Rheumatoid arthritis (RA) is a chronic disease, and therefore it is very important that you can administer the biological therapy for a long time. Therefore, so-called survival on biological treatment is observed, especially in the biological treatment registries.
The aim of the work:
To analyze the 10-year survival on adalimumab treatment and evaluate the reasons for its termination. Another objective was to evaluate predictive factors at the start of treatment for possible cessation of treatment.
Methodology:
All patients, who were enrolled in the ATTRA National Registry who met the criteria of the Czech Society fo Rheumatology for biological treatment, were included. Demographic characteristics as well as the main indicators of disease activity, such as DAS28, HAQ and EuroQuol, were assessed. Reasons for discontinuation of treatment were evaluated as primary treatment failure, secondary treatment failure and discontinuation for adverse reactions. Only patients, who were treated with adalimumab as the first biological drug and who were treated during 2003-2017, were analyzed.
Results:
In total 1598 patients with an average disease duration of 10 years and an average DAS28 at baseline of 5.7 ± 0.9 were enrolled. After 10 years of treatment, 27.7% of patients were still treated with adalimumab, the median survival was 43.9 months. The reason for treatment discontinuation was most often the loss of effect at 30.5 %, primary failure at 24.9 % and adverse events at 19.8 %. The predictive factors for longer survival were <50 years versus> 50 years (p = 0.027), maximum failure of 1 csDMARD versus 2 or more in the past (p <0.001), and combination of adalimumab with csDMARD versus monotherapy (p <0.001). Median drug survival was the longest in ankylosing spondylitis, followed by psoriatic arthritis and the shortest in rheumatoid arthritis.
Conclusion:
Adherence to treatment with adalimumab is very good and is 27.7 % after 10 years of treatment. Of the patients still on treatment, 78 % have low activity or remission. Treatment was well tolerated and no new signs of toxicity occurred.
Key words:
adalimumab, rheumatoid arthritis, registry
Sources
1. Pavelka K, Hejduk K, Mann H. Jaké jsou prediktivní faktory odpovědi na léčbu tocilizumabem v běžné klinické praxi? Zkušenosti z Českého národního registru ATTRA. Čes Revmatol 2013; 3(21): 132–9.
2. Chatzidionysiou K, Lie E, Lukina G, Hetland ML, Hauge E-M, Pavelka K, et al. Rituximab retreatment i rheumatoid arthritis in a real-life cohort: data from the CERERRA collaboration. J Rheumatol 2017; 44(2): 162–9.
3. Gabay C, Riek M, Lund Hetland M, Hauge E-M, Pavelka K, Tomšič M, Canhao H, et al. Effectiveness of tocilizumab with and without synthetic disease-modifying antirheumatic drugs in rheumatoid arthritis: results from a European collaborative study. Ann Rheum Dis 2016; 75: 1336–42.
4. Iannone F, Courvoisier DS, Gottenberg JE, Hernandez MV, Lie E, Canhao H, Pavelka K, et al. Body mas does not impact the clinical response to intravenous abatacept in patients with rheumatoid arthritis. Analysis from the „pan-European registry collaboration for abatacept (PANABA). Clin Rheumatol 2017; 36: 733–79.
5. Weinblatt ME, Keystone EC, Furst DE, et al. Adalimumab, a fully human anti-tumor necrosis factor alpha monoclonal antibody, for the treatment of rheumatoid arthritis in patients taking concomitant methotrexate: the ARMADA trial. Arthritis Rheum 2003; 48: 35–45.
6. van der Heijde D, Breedveld FC, Kavanaugh A, et al. Disease activity, physical function, and radiographic progression after longterm therapy with adalimumab plus methotrexate: 5-year results of PREMIER. J Rheumatol 2010; 37: 2237–46.
7. Smolen JS, Emery P, Fleischmann R, et al. Adjustment of therapy in rheumatoid arthritis on the basis of achievement of stable low disease activity with adalimumab plus methotrexate or methotrexate alone: the randomised controlled OPTIMA trial. Lancet 2014; 383: 321–32.
8. Furst D, Kavanaugh A, Florentinus S, et al. Final 10-year effectiveness and safety results from FE020 adalimumab treatment in patients with rheumatoid arthritis and an inadequate response to standard therapy. Rheumatology 2015; 54: 2188–97.
9. Keystone EC, Breedveld F, van der Heijde D, et al.: Long term effect of delaying combination therapy with tumor necrosis factor inhibitor in patients with aggressive early rheumatoid arthritis. 10-year efficacy and safety of adalimumab from the randomized controlled PREMIER trial with open label extension. J Rheumatol 2014; 41: 5–14.
10. Keystone EC, van der Heijde D, Kavanaugh A, et al. Clinical, functional and radiographic benefits of long-term adalimumab plus MTX: Final 10-year data in longstanding rheumatoid arthritis. J Rheumatol 2013; 40: 1487–97.
11. Burmester GR, Mariette X, Montecucco C, et al. Adalimumab alone and in combination with disease-modifying drugs for the treatment of rheumatoid arthritis in clinical practice: The Research in Active Rheumatoid Arthritis (ReAct) trial. Ann Rheum Dis 2007; 66: 732–39.
12. Nam JL, Winthrop KL, van Vollenhoven RF, Pavelka K, et al. Current evidence for the management of rheumatoid arthritis with biological disease-modifying antirheumatic drugs: a systematic literature review informing the EULAR recommendations for the management of RA. Ann Rheum Dis 2010; 69: 976–86.
13. Smolen JS, Landewé R, Bijlsma J, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis 2017; 76: 960–77.
14. Glintborg B, Østergaard M, Dreyer L, et al. Treatment response, drug survival, and predictors thereof in 764 patients with psoriatic arthritis treated with anti-tumor necrosis factor α therapy: results from the nationwide Danish DANBIO registry. Arthritis Rheum 2011; 63(2): 382–90.
15. Glintborg B, Ostergaard M, Krogh NS, et al. Predictors of treatment response and drug continuation in 842 patients with ankylosing spondylitis treated with anti-tumour necrosis factor: results from 8 years surveillance in the Danish nationwide DANBIO registry. Ann Rheum Dis 2010;69(11): 2002–08.
16. Burmester GR, Panaccione R, Gordon KB, et al. Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and Crohn´s disease. Ann Rheum Dis 2013; 72: 517–24.
Labels
Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
2018 Issue 4
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