Delphine S Courvoisier1, Katarina Chatzidionysiou2, Denis Mongin1, Kim Lauper1,3, Xavier Mariette4, Jacques Morel5, Jacques-Eric Gottenberg6, Sytske Anne Bergstra7, Manuel Pombo Suarez8, Catalin Codreanu9, Tore K Kvien10, Maria Jose Santos11, Karel Pavelka12, Merete L Hetland13,14, Johan Askling15, Carl Turesson16, Satoshi Kubo17, Yoshiya Tanaka17, Florenzo Iannone18, Denis Choquette19, Dan C Nordström20, Ziga Rotar21, Galina Lukina22, Cem Gabay1, Ronald Van Vollenhoven23, Axel Finckh1. 1. Rheumatology, University Hospitals of Geneva, Geneva, Switzerland. 2. Rheumatology, Karolinska Institutet, Stockholm, Sweden. 3. Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK. 4. Rheumatology, Université Paris Sud, AP-HP, Paris, France. 5. Rheumatology, CHU and University of Montpellier, Montpellier, France. 6. Rheumatology, University Hospital of Strasbourg, Strasbourg, France. 7. Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. 8. Rheumatology, Clinical University Hospital, Santiago de Compostela, Spain. 9. Center of Rheumatic Diseases, University of Medicine and Pharmacy, Bucharest, Romania. 10. Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. 11. Rheumatology, Hospital Garcia de Orta, Almada, Portugal. 12. Rheumatology, Charles University, Prague, Czech Republic. 13. DANBIO Registry and Copenhagen Center for Arthritis Research, Rigshospitalet, Glostrup, Denmark. 14. Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. 15. Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden. 16. Rheumatology, Skåne University Hospital, Malmö, Sweden. 17. First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan. 18. Italian Group for the Study of Early Arthritis, University Hospital of Bari, Bari, Italy. 19. Institut de Recherche en Rhumatologie de Montréal, Centre hospitalier de l'Université de Montréal and Université de Montréal, Montréal, Canada. 20. ROB-FIN Registry, Helsinki University Hospital and Helsinki University, Helsinki, Finland. 21. Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia. 22. Rheumatology, V. A. Nasonova Research Institute of Rheumatology, Moscow, Russia. 23. Rheumatology and Clinical Immunology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Abstract
OBJECTIVES: RF and ACPA are used as diagnostic tools and their presence has been associated with clinical response to some biologic DMARDs (bDMARDs) in RA. This study compared the impact of seropositivity on drug discontinuation and effectiveness of bDMARDs in patients with RA, using head-to-head comparisons in a real-world setting. METHODS: We conducted a pooled analysis of 16 observational RA registries. Inclusion criteria were a diagnosis of RA, initiation of treatment with rituximab (RTX), abatacept (ABA), tocilizumab (TCZ) or TNF inhibitors (TNFis) and available information on RF and/or ACPA status. Drug discontinuation was analysed using Cox regression, including drug, seropositivity, their interaction, adjusting for concomitant and past treatments and patient and disease characteristics and accounting for country and calendar year of bDMARD initiation. Effectiveness was analysed using the Clinical Disease Activity Index evolution over time. RESULTS: Among the 27 583 eligible patients, the association of seropositivity with drug discontinuation differed across bDMARDs (P for interaction <0.001). The adjusted hazard ratios for seropositive compared with seronegative patients were 1.01 (95% CI 0.95, 1.07) for TNFis, 0.89 (0.78, 1.02)] for TCZ, 0.80 (0.72, 0.88) for ABA and 0.70 (0.59, 0.84) for RTX. Adjusted differences in remission and low disease activity rates between seropositive and seronegative patients followed the same pattern, with no difference in TNFis, a small difference in TCZ, a larger difference in ABA and the largest difference in RTX (Lundex remission difference +5.9%, low disease activity difference +11.6%). CONCLUSION: Seropositivity was associated with increased effectiveness of non-TNFi bDMARDs, especially RTX and ABA, but not TNFis.
OBJECTIVES: RF and ACPA are used as diagnostic tools and their presence has been associated with clinical response to some biologic DMARDs (bDMARDs) in RA. This study compared the impact of seropositivity on drug discontinuation and effectiveness of bDMARDs in patients with RA, using head-to-head comparisons in a real-world setting. METHODS: We conducted a pooled analysis of 16 observational RA registries. Inclusion criteria were a diagnosis of RA, initiation of treatment with rituximab (RTX), abatacept (ABA), tocilizumab (TCZ) or TNF inhibitors (TNFis) and available information on RF and/or ACPA status. Drug discontinuation was analysed using Cox regression, including drug, seropositivity, their interaction, adjusting for concomitant and past treatments and patient and disease characteristics and accounting for country and calendar year of bDMARD initiation. Effectiveness was analysed using the Clinical Disease Activity Index evolution over time. RESULTS: Among the 27 583 eligible patients, the association of seropositivity with drug discontinuation differed across bDMARDs (P for interaction <0.001). The adjusted hazard ratios for seropositive compared with seronegative patients were 1.01 (95% CI 0.95, 1.07) for TNFis, 0.89 (0.78, 1.02)] for TCZ, 0.80 (0.72, 0.88) for ABA and 0.70 (0.59, 0.84) for RTX. Adjusted differences in remission and low disease activity rates between seropositive and seronegative patients followed the same pattern, with no difference in TNFis, a small difference in TCZ, a larger difference in ABA and the largest difference in RTX (Lundex remission difference +5.9%, low disease activity difference +11.6%). CONCLUSION: Seropositivity was associated with increased effectiveness of non-TNFi bDMARDs, especially RTX and ABA, but not TNFis.
Authors: Denis Mongin; Kim Lauper; Axel Finckh; Thomas Frisell; Delphine Sophie Courvoisier Journal: Ann Rheum Dis Date: 2022-01-13 Impact factor: 19.103
Authors: Borja Hernández-Breijo; Ioannis Parodis; Marta Novella-Navarro; Ana Martínez-Feito; Victoria Navarro-Compán; Mariana Díaz-Almirón; Dora Pascual-Salcedo; Alejandro Balsa; Chamaida Plasencia-Rodríguez Journal: J Clin Med Date: 2022-09-02 Impact factor: 4.964
Authors: Nadia M T Roodenrijs; Paco M J Welsing; Joël van Roon; Jan L M Schoneveld; Marlies C van der Goes; György Nagy; Michael J Townsend; Jacob M van Laar Journal: Rheumatology (Oxford) Date: 2022-08-30 Impact factor: 7.046