Comparative efficacy of tocilizumab, abatacept and rituximab after non‐TNF inhibitor failure: results from a multicentre study. (27th March 2016)

• Record Type: Journal Article
• Authors: Pascart, Tristan; Philippe, Peggy; Drumez, Elodie; Deprez, Xavier; Cortet, Bernard; Duhamel, Alain; Houvenagel, Eric; Flipo, René‐Marc
• Is Part Of: International journal of rheumatic diseases. Volume 19:Number 11(2016)
• Page Start: 1093
• Page End: 1102
• Publication Date: 2016-03-27
• Subjects: abatacept -- biologics failure -- rheumatoid arthritis -- rituximab -- tocilizumab; Rheumatology -- Periodicals; Rheumatology -- Asia -- Periodicals; Rheumatology -- Pacific Area -- Periodicals; Rheumatic Diseases -- Periodicals; Connective Tissue Diseases -- Periodicals; Immune System Diseases -- Periodicals; 616.723
• DOI: 10.1111/1756-185X.12845
• Languages: English
• ISSNs: 1756-1841

Abstract

Abstract: Aims: The aim of this study was to compare the efficacy of tocilizumab, rituximab and abatacept after a non‐tumor necrosis factor inhibitor (non‐TNFi) failure for the treatment of rheumatoid arthritis (RA). Materials and methods: This retrospective multi‐centre study included patients treated for RA with abatacept, rituximab or tocilizumab after having received in the previous line the first non‐TNFi. Data were collected from patient charts. The primary endpoint was the delta Disease Activity Index of 28 joints – erythrocyte sedimentation rate (DAS28‐ESR) and DAS28‐CRP (C‐reactive protein) at 12 months. The relative change in primary outcome measures from baseline were calculated. Results: One hundred patients started a second non‐TNFi between 2006 and 2013, including 15 patients treated with rituximab, 36 with tocilizumab and 49 with abatacept. The change of DAS28‐ESR was significantly different between the three groups ( P = 0.001). In post hoc pairwise comparisons, patients treated with tocilizumab had a higher decrease of the DAS28‐ESR than patients treated by abatacept (median [interquartile range: IQR]: 36% [0; 54%] vs . 0% [0; 20%], P = 0.002). A similar non‐significant difference was found between tocilizumab and rituximab (median [IQR] decrease: 36% [0; 54%] vs . 0% [−11; 34%], P = 0.07). Similar results were found with the 12 months change in DAS28‐CRP. Conclusions: This study suggests a better efficacy of tocilizumab compared with abatacept and rituximab in situations of non‐TNFi failure.