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Non-TNF-targeted drug may be more effective vs second anti-TNF drug in anti-TNF nonresponders with RA

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According to results of a recently presented study, patients with rheumatoid arthritis who did not respond to treatment with a tumor necrosis factor inhibitor and received a second biologic therapy that targeted another pathway were more likely to have better outcomes than patients who received a second tumor necrosis factor inhibitor.

Researchers studied 292 patients with rheumatoid arthritis (RA) who failed to respond to initial treatment with a tumor necrosis factor (TNF) inhibitor and randomly assigned half of the patients to a biologic medication that did not target TNF and assigned the other half of the group to receive a second TNF inhibitor. Patients were followed for 48 weeks.

At week 12, 27.7% of patients assigned to the non-TNF-targeted treatment had a good response based on EULAR criteria compared with 13.2% of patients who received a second TNF inhibitor. A moderate response was observed in 36.5% of patients who received a non-TNF-targeted therapy and by 34.6% of patients who received a second TNF inhibitor.

At 24 weeks, a good EULAR response was seen in 39.4% of patients who received a non-TNF treatment compared with 21.1% of patients who received a second TNF inhibitor. At that time, a moderate response was observed in 30.3% and 31% of patients in these groups, respectively.

At week 48, 37.7% of patients who received a non-TNF-targeted therapy were good EULAR responders compared with 21.2% of patients who received a second TNF inhibitor. About 22% of patients in each group met criteria for a moderate EULAR response to treatment.

Low disease activity was met by 40.8% of patients who received a biologic other than a TNF inhibitor compared with 23.5% of patients who received a second TNF inhibitor. Remission defined by DAS28-erythrotcyte sedimentation rate was achieved by 26.9% of patients who received a non-TNF-targeted therapy and by 13.6% of patients who received a second TNF inhibitor. – by Shirley Pulawski

Reference:

Gottenberg J, et al. Paper #3110. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

Disclosures: Gottenberg reports financial agreements with AbbVie, MSD, Pfizer, UCB and Roche. Please see the full study for a list of all other authors’ relevant financial disclosures.