Survival on treatment with second-line biologic therapy: A cohort study comparing cycling and swap strategies

Ennio Giulio Favalli, Martina Biggioggero, Antonio Marchesoni, Pier Luigi Meroni

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The aim of this study was to evaluate the survival on treatment with second-line biologic therapy in RA patient non-responders to TNF inhibitors (TNFis) by comparing treatments with a second anti-TNF (cycling strategy) or with agents with a different mechanism of action (MoA; swap strategy). Methods: RA patients treated with biologics since 1999 who stopped a first-line TNFi and started a second-line biotherapy were included in this cohort study. After adjusting for propensity scores, drug retention rates were calculated using the Kaplan-Meier method. The log-rank test was used to compare survival curves and the Cox regression model was used to compare risk for discontinuation between the two groups. Results: Two hundred and one patients discontinued the first TNFi, switching to a second anti-TNF [n = 119 (59.2%)] or to abatacept [n = 26 (31.7%)], rituximab [n = 40 (48.8%)] or tocilizumab [n=15 (18.3%)]. Drug survival was significantly higher in the swap group than in the cycling group (P

Original languageEnglish
Article numberkeu158
Pages (from-to)1664-1668
Number of pages5
JournalRheumatology
Volume53
Issue number9
DOIs
Publication statusPublished - 2014

Keywords

  • Anti-TNF
  • Biologic agents
  • Cycling
  • Drug survival
  • Mechanism of action
  • Rheumatoid arthritis
  • Swap
  • Treatment

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

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