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Drug survival of adalimumab in patients with rheumatoid arthritis over 10 years in the real-world settings: high rate remission together with normal function ability

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Abstract

The purpose of the study was to estimate the clinical profile of naïve biological patients with rheumatoid arthritis (RA) starting adalimumab through 3-year calendar periods and their clinical outcomes such as drug survival and global clinical disease control (GCDC). RA patients starting adalimumab as first biological drug between 2003 and 2012 were subdivided in 3-year calendar periods. Survival on therapy was estimated using the Kaplan-Meier analysis. One and 2-year clinical response was assessed by calculating percentage of patients attaining GCDC (28-joint Disease Activity Score (DAS28) ≤ 2.6 + Health Assessment Questionnaire (HAQ) ≤ 0.5), low disease activity (DAS28 ≤ 3.2), remission (DAS28 ≤ 2.6) and good European League Against Rheumatism (EULAR) response. Multivariate regression models were used to assess baseline predictors of drug discontinuation or achievement of clinical remission. We recruited 1695 RA patients. Overall drug persistence at 3 years was 40.6 %, while the global rate of nonswitching patients was 54.7 %. Compared to 2003–2005, initiators in more recent years had a significantly lower 3-year crude drug retention rate (log rank, p < 0.0001) and a significantly higher rate of switching to alternative biologics (log rank, p < 0.0001). No difference in adverse events or effectiveness rate among the calendar periods was found. A substantial proportion of patients (up to 27 %) achieved GCDC at 2 years, regardless of the calendar period. In real-life setting, RA patients starting adalimumab in more recent years had a higher rate of drug discontinuation not related to ineffectiveness or side effects but to switching, probably due to a wider availability of biologics. A meaningful proportion of patients attained GCDC without any difference across calendar periods.

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Acknowledgment

We thank Dr. R. Benini (CD Pharma, Milan) for assistance in statistical analysis.

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Authors and Affiliations

  1. Interdisciplinary Department of Medicine-Rheumatology Unit, Policlinico, University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy

    Florenzo Iannone & Giovanni Lapadula

  2. Rheumatology Unit, Ospedale G Pini, Milan, Italy

    Lugi Sinigaglia & Ennio Giulio Favalli

  3. Rheumatology Unit, Ospedale Sacco, Milan, Italy

    Piercarlo Sarzi-Puttini & Fabiola Atzeni

  4. Rheumatology Unit, University of Pavia, Pavia, Italy

    Roberto Caporali & Veronica Codullo

  5. Rheumatology Unit, Catholic University of the Sacred Heart, Rome, Italy

    Gianfranco Ferraccioli & Elisa Gremese

  6. Rheumatology Unit, University of Verona, Verona, Italy

    Antonio Carletto & Alessandro Giollo

  7. Rheumatology Unit, University of Ferrara, Ferrara, Italy

    Marcello Govoni & Francesca Bergossi

  8. Rheumatology Unit, University of Siena, Siena, Italy

    Mauro Galeazzi & Luca Cantarini

  9. Rheumatology Unit, Università Politecnica delle Marche, Jesi, Italy

    Fausto Salaffi & Marco Di Carlo

  10. Rheumatology Unit, University of Brescia, Brescia, Italy

    Chiara Bazzani

  11. Rheumatology Unit, Ospedale Mauriziano, Torino, Italy

    Raffaele Pellerito

  12. Rheumatology Unit, University of Modena e Reggio Emilia, Modena, Italy

    Marco Sebastiani

  13. Rheumatology Unit, University of Padova, Padova, Italy

    Roberta Ramonda

Authors
  1. Florenzo Iannone
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  2. Lugi Sinigaglia
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  3. Ennio Giulio Favalli
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  4. Piercarlo Sarzi-Puttini
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  5. Fabiola Atzeni
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  6. Roberto Caporali
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  7. Veronica Codullo
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  8. Gianfranco Ferraccioli
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  9. Elisa Gremese
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  10. Antonio Carletto
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  11. Alessandro Giollo
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  12. Marcello Govoni
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  13. Francesca Bergossi
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  14. Mauro Galeazzi
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  15. Luca Cantarini
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  16. Fausto Salaffi
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  17. Marco Di Carlo
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  18. Chiara Bazzani
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  19. Raffaele Pellerito
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  20. Marco Sebastiani
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  21. Roberta Ramonda
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  22. Giovanni Lapadula
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Corresponding author

Correspondence to Florenzo Iannone.

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Disclosures

Florenzo Iannone has received consulting fees, speaking fees or honoraria (less than €10,000) from Pfizer, Merck, Abbvie and Bristol-Myers Squibb.

Funding

The study was supported by an unrestricted research grant from AbbVie srl.

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Iannone, F., Sinigaglia, L., Favalli, E.G. et al. Drug survival of adalimumab in patients with rheumatoid arthritis over 10 years in the real-world settings: high rate remission together with normal function ability. Clin Rheumatol 35, 2649–2656 (2016). https://doi.org/10.1007/s10067-016-3349-z

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  • DOI: https://doi.org/10.1007/s10067-016-3349-z

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