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SAT0125 Comparing the long-term clinical outcome of etanercept and adalimumab treatment with respect to immunogenicity
  1. C. Krieckaert1,
  2. A. Jamnitski1,
  3. M. Nurmohamed1,
  4. P. Kostense2,
  5. M. Boers2,
  6. G. Wolbink1
  1. 1Rheumatology, Jan Van Breemen Research Institute | Reade
  2. 2Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, Netherlands


Objectives To compare rates of sustained low and minimal disease activity and ACR/EULAR remission during 3-year follow-up in rheumatoid arthritis (RA) patients treated with etanercept and adalimumab in routine care.

Methods 407 RA patients previously unexposed to tumor necrosis factor antagonists were treated with etanercept (n=203) or adalimumab (n=204) and assessed at 3- and later 6 month intervals. Clinical parameters and anti-adalimumab antibodies (AAA) were measured at each time point. Clinical response was defined as sustained (at least 12 consecutive months) low disease activity (sLDA; DAS28 <3.2), minimal disease activity (sMDA; DAS28 <2.6) or ACR/EULAR remission (sSDAI). Non-overlapping response rates were calculated.

Results In the adalimumab group, 13% reached sLDA but not sMDA, 15% reached sMDA but not sSDAI and 16% reached sSDAI remission. In the etanercept group corresponding rates were 16%, 11% and 12%, respectively (overall test for linear trend: p=0.42). Adalimumab-treated patients without antibodies (AAA–; n=150, 74%) had best outcomes and AAA+ patients the worst, with etanercept-treated patients in between (p<0.0001). Differences were most apparent in the sSDAI and sMDA categories. For example, 40% of AAA–, 23% of etanercept and 4% of AAA+ patients achieved at least sMDA (Fig. 1).

Conclusions Overall, etanercept and adalimumab treatment appeared similar in inducing a good long-term clinical outcome. The occurrence of AAA hampered the long-term clinical efficacy of adalimumab. Treatment response rates to adalimumab might be increased by strategies that counteract the development of AAA.

Disclosure of Interest C. Krieckaert: None Declared, A. Jamnitski: None Declared, M. Nurmohamed Grant/Research support from: Abbott, Roche, Pfizer, Consultant for: Abbott, Roche, Phizer, MSD, UCB, SOBI and BMS, Speakers Bureau: Abbott, Roche, Pfizer, P. Kostense: None Declared, M. Boers Consultant for: Roche, GSK, Novartis, Speakers Bureau: UCB, Abbott, G. Wolbink Grant/Research support from: Pfizer, Speakers Bureau: Pfizer, Amgen

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