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Study: Discontinuation of biologics high in Canadian patients with RA

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High discontinuation rates of biologics were seen in a Canadian cohort of patients with rheumatoid arthritis, according to data presented at the American College of Rheumatology Annual Meeting.

Researchers prospectively identified 623 patients in the RHUMADATA database from the Institut de Rhumatologie de Montréal with confirmed rheumatoid arthritis (RA). The database included clinical, laboratory and socioeconomic data. Patients were eligible if they were treated with at least one biologic since 2003 and were followed for 3 years or until treatment discontinuation.

Biologics administered to patients with RA during the study included Orencia (abatacept, Bristol-Myers-Squibb), adalimumab, Kineret (anakinra, Swedish Orphan Biovitrum), Cimzia (certolizumab pegol, UCB), Enbrel (etanercept, Amgen), Simponi (golimumab, Janssen), Remicade (infliximab, Janssen), Rituxan (rituximab, Genentech/Biogen IDEC) and Actemra (tocilizumab, Genentech). Discontinuation of treatment was measured using pharmacy records. The researchers used Cox proportional models to determine time to discontinuation and predictors of treatment discontinuation. Average time on treatment for a first-time biologic was 1.7 years.

At 6 months, 37% of patients stopped therapy with biologics. At 12 months, the percentage of patients who stopped therapy was 52%; 65% stopped therapy at 24 months, and 70% stopped therapy at 36 months.

The researchers found patients’ type of work and income ($20,000 to $40,000 vs. < $20,000) were significantly associated with the discontinuation of therapy during the study period. The number of disease-modifying anti-rheumatic drugs used and the use of methotrexate were associated with a lower risk of discontinuation.

Reference:

Coupal L, et al. Paper #499. Presented at: American College of Rheumatology Annual Meeting. Nov. 14-19, 2014; Boston.

Disclosure: Coupal has no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.