FRI0112 Persistence on tumour necrosis factor inhibitor (TNFI) monotherapy after achieving remission or low disease activity (LDA) on combination therapy among patients with rheumatoid arthritis (RA). (12th June 2018)

• Record Type: Journal Article
• Authors: Pappas, D.A.; Litman, H.J.; Lesperance, T.; Rebello, S.; Karis, E.; Kricorian, G.; Hua, W.; Accortt, N.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 600
• Page End: 601
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.1509
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Combination therapy with TNFis and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) is standard for moderate to severe RA. Objectives: To estimate persistence with etanercept (ETN) or other TNFi monotherapy among RA patients who achieved remission/LDA on combination TNFi +csDMARD therapy and then discontinued the csDMARD. Methods: Data from RA patients in the Corrona registry during 10/1/2001–8/31/2017 were analysed. All patients had to be treated with TNFi +csDMARD combination therapy and to have reached Clinical Disease Activity Index remission/LDA and then discontinue the csDMARD (index date). ETN (fusion protein comprising TNF receptor and human IgG1 Fc) and other TNFi therapies (monoclonal antibodies: adalimumab, certolizumab pegol, golimumab, and infliximab) were analysed separately. Outcomes were percentages of patients persistent on index TNFi monotherapy, discontinued index TNFi, switched (to another biologic or to csDMARD monotherapy), or added csDMARD therapy (to receive combination therapy) at 6 months (primary analysis) and 12 months post-index. Results: Data from 617 patients were analysed (182 ETN, 435 other TNFi); mean age (standard deviation [SD]) was 57.4 (13.3) years, 73% were female. Mean time (SD) in remission/LDA before csDMARD discontinuation was 17.0 (24.3) months. Rates of monotherapy persistence at 6 months were 56% for ETN and 45% for other TNFi (table 1). Patients with ≥6 month persistence on monotherapy had mean duration (SD) of 28.2 (22.1) months on ETN monotherapy or 27.8 (23.3) months on other TNFi monotherapy. Rates of persistence for all patients at 12 months were 46% for ETN and 33% for other TNFi. Patients with ≥12 month persistence had mean duration (SD) of 35.9 (22.6) months on ETN monotherapy or 39.3 (24.4) months on other TNFi monotherapy. For a subset of patients with <6 months in remission/LDA before index date (44% of patients), rates of monotherapy persistence at 6 months were 60% for ETN and 42% for other TNFi. Conclusions: Monotherapy with ETN or other TNFi is an option for patients in remission/LDA;>50% of patients on ETN remained on monotherapy 6 months after discontinuing their csDMARD. Acknowledgements: This study was sponsored by Corrona, LLC and the analysis was funded by Amgen Inc. Disclosure of Interest: D. Pappas Employee of: Corrona, LLC, H. Litman Employee of: Corrona, LLC, T. Lesperance Consultant for: Amgen Inc., S. Rebello Employee of: Corrona, LLC, E. Karis Shareholder of: Amgen Inc., Employee of: Amgen Inc., G. Kricorian Shareholder of: Amgen Inc., Employee of: Amgen Inc., W. Hua Employee of: Corrona, LLC, N. Accortt: None declared