There is an association between discontinuation of biologic therapy in patients with rheumatoid arthritis (RA) and using a lower number of disease-modifying antirheumatic drugs (DMARDs) or not using concomitant methotrexate.
A Canadian team funded by AbbVie Corporation used a database of approximately 22,800 patients with inflammatory disease in Quebec. They focused on 623 adults who had been diagnosed with RA and had been treated with at least one biologic since 2003. Their average age was 53.2 years and 77.1% were women. Furthermore, average disease duration was 7.7 years.
Two hundred and thirty-three patients (37%) had stopped their first biologic treatment after 6 months, while 326 (52%), 405 (65%), and 438 (70%) had done so after 12, 24, and 36 months, respectively. The patients’ average time on their first biologic agent was 1.7 years.
The investigators constructed Cox proportional hazard models that showed working part time was associated with a 57% higher probability of biologic discontinuation over the complete treatment duration compared with working full time, with a hazard ratio (HR) of 1.57. Annual incomes of either $20,000 to $39,999 or $80,000 to $99,999 were both associated with a higher probability of biologic discontinuation than earning less than $20,000, with HRs of 1.35 and 2.16, respectively.
The 2 factors the researchers found to be associated with a lower probability of biologic discontinuation were use of a higher number of DMARDs (HR=0.89) and the concomitant use of methotrexate (HR=0.80).
“AbbVie is interested in the topic of treatment adherence, as we are committed to improving the treatment experience for people living with chronic diseases. We hope that by better understanding the factors associated with lower adherence and treatment discontinuation, we can improve patient outcomes,” according to a statement sent to Value-Based Care in Rheumatology by Scott C. Brun, MD, Vice President, Pharmaceutical Development, AbbVie, Saint-Laurent, Quebec.
Choquette D, Laliberté M-C, Desjardins O, et al. Biologic discontinuation in rheumatoid arthritis: experience from Canadian clinics. In: Proceedings from the ISPOR 20th International Annual Meeting; May 16-20, 2015; Philadelphia, PA. Abstract PMS60.