Golimumab Improves Disease Activity in Patients With RA

In patients with rheumatoid arthritis (RA) with a failure response to intravenous (IV) infliximab, switching to IV-golimumab was proven effective in improving disease activity, according to a study published in Springer.¹

“Some patients treated with [a] tumor necrosis factor inhibitor (TNFi) fail to achieve low disease activity, lose response over time, or experience adverse events, often prompting a dose increase, switch to a different TNFi, or switch to a biologic with a different mechanism of action,” investigators stated. “Such patients may benefit from switching to a fully human biologic, such as IV-golimumab, to control disease activity/improve drug tolerance.”

The retrospective, longitudinal single-arm study utilized the American College of Rheumatology’s (ACR’s) Rheumatology Informatics System for Effectiveness (RISE) data to discern differences in disease activity in patients switching from IV-infliximab to IV-golimumab. RISE is a large electronic heath records (EHR) registry that holds information about demographics, diagnoses, medication, laboratory results, disease activity scores, and procedures from 1.6 million patients.

Patients were aged 18 years or older, had a diagnosis of RA between 2014 and 2018, at least 1 IV-infliximab prescription within 6 months of their latest IV-golimumab prescription, and a rheumatoid arthritis disease activity (RADA) measure at both baseline and 1 or more times during the follow-up periods. Disease activity assessments were calculated using the Clinical Disease Activity Index (CDAI). Demographics, including age, race, ethnicity, sex, insurance type, and geographic regions were analyzed within the 12-month period.

At enrollment, most patients with RA reported moderate-to-high disease activity (CDAI: 73% [38/52]). The mean age was 65.3 years, 81% were female, and 74% were White. Of the eligible patients with a baseline and follow-up RADA measure, 100 and 63 had IV-golimumab persistence at the ≥ 6 and ≥ 9 month follow-ups, respectively.

Of the 52 patients with CDAI information available at 6 months, patients showed significant improvements in disease activity, with scores improving from 21.3 to 14.1 (p < 0.0001), which remained through 12 months. Disease activity decreased from 73% to 56% and low or remitted disease activity increased from 27% to 44% (p < 0.001).

Patients who used IV-golimumab during the follow-up periods were included, which may have possibly created a responder/selection bias. Confounding by indication may have occurred due to the single-arm, longitudinal study design. The reasons for patients switching medications, the length of time on IV-infliximab, and dose changes were not included in the study. Lastly, the follow-up period was comparably short for patients with RA. Longer studies will be beneficial in analyzing the long-term effectiveness of this medication.

“Results of this study using RISE data suggest that IV-golimumab is effective in improving RA disease activity in a patient population switching directly from IV-infliximab,” investigators concluded. “Given the limited real-world data documenting efficacy of IV-infliximab-to-IV-golimumab switching, these results are clinically meaningful and may assist clinicians in providing patients with improved and sustained outcomes.”

Reference:

Tesser J, Lin I, Shiff NJ, et al. Improvement in disease activity among patients with rheumatoid arthritis who switched from intravenous infliximab to intravenous golimumab in the ACR RISE registry [published online ahead of print, 2022 Mar 21]. Clin Rheumatol. 2022;10.1007/s10067-022-06116-z. doi:10.1007/s10067-022-06116-z