Golimumab effectiveness in biologic inadequate responding patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis in real-life from the Italian registry GISEA - 04/09/20
, Ennio G. Favalli b, Roberto Caporali c, Salvatore D’Angelo d, Francesco Paolo Cantatore e, Piercarlo Sarzi-Puttini f, Rosario Foti g, Fabrizio Conti h, Antonio Carletto i , Elisa Gremese j, Alberto Cauli k, Roberta Ramonda l, Adalgisa Palermo m, Oscar Epis n, Marta Priora o, Francesca Bergossi p, Bruno Frediani q, Fausto Salaffi r, Giuseppe Lopalco a, Fabio Cacciapaglia a, Antonio Marchesoni b, Martina Biggioggiero b, Serena Bugatti c, Silvia Balduzzi c, Antonio Carriero d, Addolorata Corrado e, Sara Bongiovanni f, Alessia Benenati g, Francesca Miranda h, Elena Fracassi i, Daniela Perra k, Gianfranco Ferraccioli j, Giovanni Lapadula aThis article has been published in an issue click here to access
Highlights |
• | In a large cohort of patients with SpA and PsA from the real life, golimumab has shown to be as effective in 1-biologic IR as in biologic-naive patients, with comparable drug survival and clinical outcomes. |
• | RA biologic-naive patients showed a significant better response to golimumab than 2≥-biologic IR patients. A slight difference between naïve-biologic and 1-biologic IR patients was seen. |
• | MTX co-therapy increased the retention rate of golimumab in RA but not in SpA or PsA patients. |
Abstract |
Objective |
To evaluate the clinical effectiveness of golimumab in biologic inadequate responder (IR) patients with Rheumatoid arthritis (RA), Spondyloarthritis (SpA), and Psoriatic arthritis (PsA).
Methods |
We analyzed 1424 patients on golimumab from the GISEA registry. Drug survival was estimated by Kaplan-Meier analysis in biologic-naïve, 1-biologic IR, ≥2-biologics IR patients. Hazard ratios (HRs) of discontinuing golimumab at 2 years were assessed by multivariate Cox regression. Patients achieving CDAI based low disease activity (LDA) or BASDAI<4 were calculated at 6 and 12 months.
Results |
In RA (n.370), the 2-years survival on golimumab was 61.4% in 1-biologic IR, 51.9% in≥2-biologics IR, and 73.1% in biologic-naive patients (P=0.002 vs≥2-biologics IR). In SpA (n.502), the survival was similar among 1-biologic IR (80%), ≥2-biologics IR (76.5%), and biologic-naive (74.6%) patients (P>0.05). In PsA (n.552) the survival was 72% in 1-biologic IR, 72.5% in≥2-biologics IR, and 71.8% in naïve-biologic (P>0.05). Predictors of golimumab discontinuation were monotherapy (HR 1.65) for RA, female gender for SpA (HR 2.48) and PsA (HR 1.57). In RA, patients on CDAI-LDA were lower in 1-biologic IR (40%) or≥2 biologics IR (40%) than in biologic-naïve (60%) group at 6 months (P=0.02), but no difference was observed at 12 months. In PsA and SpA, the percentage of patients on CDAI-LDA or BASDAI<4 at 6 months was almost identical across the subgroups.
Conclusions |
Golimumab had similar effectiveness in biologic-failure and biologic-naïve SpA and PsA, but seems to be less effective in multi-failure RA patients, especially as monotherapy. The best outcomes were seen in male patients.
El texto completo de este artículo está disponible en PDF.Keywords : Biologics, Anti-TNF, Golimumab
Esquema
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