Two-year persistence of golimumab as second-line biologic agent in rheumatoid arthritis as compared to other subcutaneous tumor necrosis factor inhibitors: Real-life data from the LORHEN registry

Ennio G. Favalli, Luigi Sinigaglia, Andrea Becciolini, Vittorio Grosso, Roberto Gorla, Chiara Bazzani, Fabiola Atzeni, Pier C. Sarzi Puttini, Enrico Fusaro, Raffaele Pellerito, Roberto Caporali

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To evaluate the 2-year retention rate of golimumab compared with etanercept and adalimumab as second-line biologic agent in rheumatoid arthritis (RA) patients who failed a previous tumor necrosis factor inhibitor (TNFi). Methods: Data on RA patients treated with a second-line subcutaneous TNFi were extracted from a multicentric Italian cohort (the LORHEN registry). The analysis was limited to etanercept, adalimumab and golimumab in the period when all were available in Italy (since October 2010). The 2-year retention rate was calculated by Kaplan–Meier method and the comparative risk for discontinuation among individual TNFi was compared by a stratified log-rank test. Results: One hundred and ninety-five RA patients treated with etanercept (n = 76), adalimumab (n = 68) or golimumab (n = 51) were included in the analysis. The 2-year retention rate (40% with a median time-on-drug of 12.9 months in the whole population) was significantly lower for adalimumab (31.2%, P = 0.018) and numerically lower for etanercept (39.8%, P = 0.068) compared with golimumab (53.4%) because of a higher discontinuation rate due to adverse events (P = 0.042 and P = 0.038 versus golimumab, respectively). Drug survival was greater in concomitant synthetic disease modifying anti-rheumatic drug (sDMARD) users (44.2%) compared with TNFi monotherapy (22.5%, P = 0.036). No difference was found in survival analysis according to first-line TNFi reason for discontinuation and pattern of TNFi switch (antibody-receptor, antibody-antibody or receptor-antibody). Conclusions: Our real-life data confirmed switching to a second TNFi as a good option for treating first-line TNFi failures in RA, especially in combination with sDMARDs. Second-line golimumab showed an overall better 2-year drug survival compared with adalimumab and etanercept.

Original languageEnglish
Pages (from-to)422-430
Number of pages9
JournalInternational Journal of Rheumatic Diseases
Volume21
Issue number2
DOIs
Publication statusPublished - Jan 1 2018

Keywords

  • Anti-TNF
  • Biologic agents
  • Drug survival
  • Golimumab
  • Rheumatoid arthritis
  • Second line
  • Treatment

ASJC Scopus subject areas

  • Rheumatology

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