Study Compares Persistence of bDMARDs in Real-World Setting

A recent study is suggest treatment with tocilizumab for patients with rheumatoid arthritis with a history of using other biologics had similar or better biologic persistence compared with other popular biologics.

The study, which was presented at the Clinical Congress of Rheumatology (CCR) West 2019 annual meeting in San Diego, CA, examined use of abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, and tocilizumab as a subseuqnet-line therapy after an inadequate response to or intolerance of first-line biologic disease-modifying anti rheumatic drugs (bDMARDs).

Presented by Jennie Best, MD, principal health economist with Genentech, results of the study revealed Elixhauser comorbidity scores were significantly higher (P<0.001) for tocilizumab (2.8) compared to abatacept (2.5), adalimumab (2.5), certolizumab pegol(2.4), etanercept (2.4), or golimumab (2.4).

The study examined a cohort of 10,301 patients with 12,704 bDMARD epsiodes. Investigators observed median days (95% CI) of persistence were 320 with abacept, 280 with adalimumab, 262 with certolizumab pegol, 289 with etanercept, 304 golimumab, and 333 with tocilizumab.

Patients who received tocilizumab had significantly (P<0.05) higher persistence compared to adalimumab, certolizumab pegol, and etanercept—investigators noted among patients who were observed for 12 months, 45% initiated tocilizumab bi-weekly and 55% initiated weekly.

To understand more about how the results of this study can impact real-world practice, Best took part in a Q&A with MD Magazine® about the study, which is titled “Comparison of Real-World Persistence of Subcutaneously Administered Biologic Disease- Modifying Antirheumatic Drug Therapies Among Patients With Rheumatoid Arthritis Switching From Another Biologic”.

MD Mag: What was the biggest takeaway from your study in terms of real-world application?

Best: Patients who received tocilizumab had similar or significantly better persistence compared with other bDMARDs. The difference in persistence may reflect inadequate response to treatment, treatment failure, side effects, or other reasons. The results of this analysis may help inform providers, payers, and patients about the comparative effectiveness of biologic agents in real-world clinical practice.

MD Mag: Was there anything about the results of the study that you were surprised by or may not have been expecting?

Best: The results of this study of patients who received tocilizumab SC were consistent with data that were published previously (Johnston S et al) that showed that patients receiving Actemra IV had higher persistency than other IV biologics.