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50% of patients with RA discontinued biologics within 2 years

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Patients with rheumatoid arthritis discontinued approximately one-third of biologic therapies at 1 year and one-half at 2 years, according to research presented at the annual congress of the European League Against Rheumatism in Madrid.

“Studies have shown that patients sustain maximum benefit from RA treatment in the first two years — yet our data highlight significant discontinuation rates during this time period,” researcher Vibeke Strand, MD, clinical professor at Stanford University School of Medicine, said in a press release.

 

Vibeke Strand

Researchers studied 6,209 patients with rheumatoid arthritis (RA; mean age, 56.6 years; 78.5% women) who were included in the U.S. Consortium of Rheumatology Researchers of North America database between 2002-2011. Patients were older than age 18 years, with RA onset coming after age 16, and had at least 6 months’ follow-up after first or subsequent biologic therapy initiation. Tumor necrosis factor (TNF) inhibitors (TNFi) and non-TNFi were biologic agents included in the study. Therapy discontinuation was defined as the first report of stopping treatment or initiation of a new biologic and/or between visits on a follow-up questionnaire.

Patients had a median RA duration of 8 years; 43.4% were biologic naive and 26.1% had a Clinical Disease Activity Index (CDAI) of more than 22. TNFi therapy was received by 80.7% of patients (n=5,010); non-TNFi was used by 19.3% of patients (n=1,199). Overall median time to discontinuation or change of therapy was 25.1 months, with 82.2% of patients remaining on initial therapy at 6 months and 67.3% at 1 year.

For patients receiving TNFi, median time to discontinuation was 26.5 months, compared with 20.5 months for non-TNFi patients (P<.0001). Overall proportions remaining on TNFi were 82.5%, 68.2% and 52.2% at 6, 12 and 24 months, compared with 80.9%, 63.4% and 46% on non-TNFi, respectively.

Loss of efficacy (35.8%), physician preference (27.8%), safety (20.1%) and patient preference (17.9%) were the most common reasons among 3,584 discontinuations.

“These data were derived from a U.S. experience, which is associated with a significantly greater prevalence of biologic utilization than is typically seen elsewhere,” Strand said. “The results may, therefore, be different in societies with less prevalent utilization of these agents.”

Disclosure: See the abstract for a full list of relevant disclosures.

For more information:

Strand V. OP0064: Discontinuation of Biologic Therapy in Rheumatoid Arthritis (RA): Analysis from the Consortium of Rheumatology Researchers of North America (CORRONA). Presented at: EULAR 2013; June 12-15, Madrid.