Comparison of long-term efficacy between biological agents following tumor necrosis factor inhibitor failure in patients with rheumatoid arthritis: a prospective cohort study

Background: Currently, there is contradictory evidence regarding the best strategy to follow after discontinuation of a first biological agent in patients with rheumatoid arthritis (RA). We aimed to compare the long-term efficacy of switching to a second tumor necrosis factor inhibitor (TNFi) versus...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Patricia Bogas, Chamaida Plasencia-Rodriguez, Victoria Navarro-Compán, Carolina Tornero, Marta Novella-Navarro, Laura Nuño, Ana Martínez-Feito, Borja Hernández-Breijo, Alejandro Balsa
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/37304551fe53486ea600c139c7bab59b
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:37304551fe53486ea600c139c7bab59b
record_format	dspace
spelling	oai:doaj.org-article:37304551fe53486ea600c139c7bab59b2021-12-01T00:06:40ZComparison of long-term efficacy between biological agents following tumor necrosis factor inhibitor failure in patients with rheumatoid arthritis: a prospective cohort study1759-721810.1177/1759720X211060910https://doaj.org/article/37304551fe53486ea600c139c7bab59b2021-11-01T00:00:00Zhttps://doi.org/10.1177/1759720X211060910https://doaj.org/toc/1759-7218Background: Currently, there is contradictory evidence regarding the best strategy to follow after discontinuation of a first biological agent in patients with rheumatoid arthritis (RA). We aimed to compare the long-term efficacy of switching to a second tumor necrosis factor inhibitor (TNFi) versus biopharmaceuticals with other mechanisms of action (non-TNFi) in patients with RA who previously failed a first TNFi. Methods: This prospective cohort study analyzed data from 127 patients who discontinued a previous TNFi between 1999 and 2016. Disease activity was assessed at baseline and at 6, 12, and 24 months (m-6, m-12, m-24) after switching. Primary outcome was the proportion of patients achieving good/moderate EULAR response (E-resp). Factors associated with clinical outcomes were assessed using univariate and multivariate logistic regression models. Results: Seventy-seven (61%) patients received a second TNFi and 50 (39%) switched to a non-TNFi. At m-6 and m-12, no differences were observed between groups; nevertheless, at m-24, the proportion of patients with E-resp was higher in the non-TNFi group (49% TNFi group versus 77% non-TNFi group; p = 0.002). In regression models, switching to a non-TNFi was significantly associated with E-resp at m-24 (odds ratio = 3.21; p = 0.01). When assessing the response to the second biological agent based on the reason for discontinuation of the first TNFi, similar results were obtained; at m-24, patients who discontinued the first TNFi due to inefficacy (either primary or secondary) experienced a better E-resp if they had switched to a non-TNFi (primary inefficacy: 52% TNFi group versus 79% non-TNFi group, p = 0.09; secondary inefficacy: 50% versus 76%, p = 0.03). Conclusion: In our cohort of RA patients who discontinued a first TNFi, those who switched to a non-TNFi were three times more likely to attain a sustained clinical response, regardless of whether they had discontinued the first biologic due to a primary or secondary inefficacy.Patricia BogasChamaida Plasencia-RodriguezVictoria Navarro-CompánCarolina TorneroMarta Novella-NavarroLaura NuñoAna Martínez-FeitoBorja Hernández-BreijoAlejandro BalsaSAGE PublishingarticleDiseases of the musculoskeletal systemRC925-935ENTherapeutic Advances in Musculoskeletal Disease, Vol 13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the musculoskeletal system RC925-935
spellingShingle	Diseases of the musculoskeletal system RC925-935 Patricia Bogas Chamaida Plasencia-Rodriguez Victoria Navarro-Compán Carolina Tornero Marta Novella-Navarro Laura Nuño Ana Martínez-Feito Borja Hernández-Breijo Alejandro Balsa Comparison of long-term efficacy between biological agents following tumor necrosis factor inhibitor failure in patients with rheumatoid arthritis: a prospective cohort study
description	Background: Currently, there is contradictory evidence regarding the best strategy to follow after discontinuation of a first biological agent in patients with rheumatoid arthritis (RA). We aimed to compare the long-term efficacy of switching to a second tumor necrosis factor inhibitor (TNFi) versus biopharmaceuticals with other mechanisms of action (non-TNFi) in patients with RA who previously failed a first TNFi. Methods: This prospective cohort study analyzed data from 127 patients who discontinued a previous TNFi between 1999 and 2016. Disease activity was assessed at baseline and at 6, 12, and 24 months (m-6, m-12, m-24) after switching. Primary outcome was the proportion of patients achieving good/moderate EULAR response (E-resp). Factors associated with clinical outcomes were assessed using univariate and multivariate logistic regression models. Results: Seventy-seven (61%) patients received a second TNFi and 50 (39%) switched to a non-TNFi. At m-6 and m-12, no differences were observed between groups; nevertheless, at m-24, the proportion of patients with E-resp was higher in the non-TNFi group (49% TNFi group versus 77% non-TNFi group; p = 0.002). In regression models, switching to a non-TNFi was significantly associated with E-resp at m-24 (odds ratio = 3.21; p = 0.01). When assessing the response to the second biological agent based on the reason for discontinuation of the first TNFi, similar results were obtained; at m-24, patients who discontinued the first TNFi due to inefficacy (either primary or secondary) experienced a better E-resp if they had switched to a non-TNFi (primary inefficacy: 52% TNFi group versus 79% non-TNFi group, p = 0.09; secondary inefficacy: 50% versus 76%, p = 0.03). Conclusion: In our cohort of RA patients who discontinued a first TNFi, those who switched to a non-TNFi were three times more likely to attain a sustained clinical response, regardless of whether they had discontinued the first biologic due to a primary or secondary inefficacy.
format	article
author	Patricia Bogas Chamaida Plasencia-Rodriguez Victoria Navarro-Compán Carolina Tornero Marta Novella-Navarro Laura Nuño Ana Martínez-Feito Borja Hernández-Breijo Alejandro Balsa
author_facet	Patricia Bogas Chamaida Plasencia-Rodriguez Victoria Navarro-Compán Carolina Tornero Marta Novella-Navarro Laura Nuño Ana Martínez-Feito Borja Hernández-Breijo Alejandro Balsa
author_sort	Patricia Bogas
title	Comparison of long-term efficacy between biological agents following tumor necrosis factor inhibitor failure in patients with rheumatoid arthritis: a prospective cohort study
title_short	Comparison of long-term efficacy between biological agents following tumor necrosis factor inhibitor failure in patients with rheumatoid arthritis: a prospective cohort study
title_full	Comparison of long-term efficacy between biological agents following tumor necrosis factor inhibitor failure in patients with rheumatoid arthritis: a prospective cohort study
title_fullStr	Comparison of long-term efficacy between biological agents following tumor necrosis factor inhibitor failure in patients with rheumatoid arthritis: a prospective cohort study
title_full_unstemmed	Comparison of long-term efficacy between biological agents following tumor necrosis factor inhibitor failure in patients with rheumatoid arthritis: a prospective cohort study
title_sort	comparison of long-term efficacy between biological agents following tumor necrosis factor inhibitor failure in patients with rheumatoid arthritis: a prospective cohort study
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/37304551fe53486ea600c139c7bab59b
work_keys_str_mv	AT patriciabogas comparisonoflongtermefficacybetweenbiologicalagentsfollowingtumornecrosisfactorinhibitorfailureinpatientswithrheumatoidarthritisaprospectivecohortstudy AT chamaidaplasenciarodriguez comparisonoflongtermefficacybetweenbiologicalagentsfollowingtumornecrosisfactorinhibitorfailureinpatientswithrheumatoidarthritisaprospectivecohortstudy AT victorianavarrocompan comparisonoflongtermefficacybetweenbiologicalagentsfollowingtumornecrosisfactorinhibitorfailureinpatientswithrheumatoidarthritisaprospectivecohortstudy AT carolinatornero comparisonoflongtermefficacybetweenbiologicalagentsfollowingtumornecrosisfactorinhibitorfailureinpatientswithrheumatoidarthritisaprospectivecohortstudy AT martanovellanavarro comparisonoflongtermefficacybetweenbiologicalagentsfollowingtumornecrosisfactorinhibitorfailureinpatientswithrheumatoidarthritisaprospectivecohortstudy AT lauranuno comparisonoflongtermefficacybetweenbiologicalagentsfollowingtumornecrosisfactorinhibitorfailureinpatientswithrheumatoidarthritisaprospectivecohortstudy AT anamartinezfeito comparisonoflongtermefficacybetweenbiologicalagentsfollowingtumornecrosisfactorinhibitorfailureinpatientswithrheumatoidarthritisaprospectivecohortstudy AT borjahernandezbreijo comparisonoflongtermefficacybetweenbiologicalagentsfollowingtumornecrosisfactorinhibitorfailureinpatientswithrheumatoidarthritisaprospectivecohortstudy AT alejandrobalsa comparisonoflongtermefficacybetweenbiologicalagentsfollowingtumornecrosisfactorinhibitorfailureinpatientswithrheumatoidarthritisaprospectivecohortstudy
_version_	1718406132561608704

Comparison of long-term efficacy between biological agents following tumor necrosis factor inhibitor failure in patients with rheumatoid arthritis: a prospective cohort study

Ejemplares similares