Background Many studies have evaluated the average time on a current biologic for anti-TNF drugs that treat inflammatory conditions such as rheumatoid arthritis (RA). However there is little research comparing the difference of the average time on a current biologic between anti-TNF and non-anti-TNF drugs in the treatment of RA.
Objectives The objective of this study was to examine the differences in long-term biologic prescribing behaviour in a large observational cohort of RA patients (pts).
Methods The Research Partnership has conducted an online survey among a panel of 240 rheumatologists between January and December 2013 across five EU countries (France, Germany, Italy, Spain and the UK) that includes anonymised data of pts therapy as prescribed by their doctor. We have evaluated the pts' current treatment regimen for biologic drugs, used both in monotherapy (pts treated only with a biologic drug) or combination therapy (pts treated with a biologic drug and a DMARD) according to their line of therapy.
Results We have used a sample of 25,293 pts, 14,543 of which were prescribed monotherapy or combination therapy (fig. 1). Figure 2 shows their treatment regimen based on their line of therapy. Figure 3 shows the time spent on their current biologic based on their treatment regimen and their line of therapy (values expressed in average months). Results are based on two-sided tests with significance level 0.05.
The average time on their current biologic was statistically significantly higher for adalimumab (37.6) and etanercept (36.8) in monotherapy first line pts, closely followed by rituximab (23.4), infliximab (22.2) and abatacept (21.5). On the other hand, the average time on their current biologic was statistically significantly higher for infliximab (47.5) amongst combination therapy first line pts.
Looking at the second line of therapy, the average time on their current biologic in monotherapy was 38 months for etanercept, this was statistically significantly higher than other bioloigics like adalimumab (36.7), rituximab (26.2) or infliximab (23.8). In the same way, etanercept had the highest average time as current biologic in a combination therapy with 32.3 months followed by adalimumab (29.1) both being statistically significant.
Finally, for third and above lines of therapy adalimumab was statistically significant as the highest, with 50 months the average time as current biologic in a monotherapy. Also in monotherapy rituximab (26.7) was statistically significant compared to etanercept (3.4) and tocilizumab (18.1), and abatacept (21.6) compared to etanercept; adalimumab (36.7), infliximab (31.6) and rituximab (29.7) had a statistically significant higher time as current biologics.
Conclusions These data show that non-anti-TNF drugs have a reduced average time as current biologic compared to anti-TNF drugs for first and second line of therapy. When looking at the third line of therapy rituximab and abatacept show a greater average time as current biologic compared to some anti-TNF. The average time as current biologic in both monotherapy and combo therapy for the first and second lines did not show significant difference. However, for third and above lines of therapy we have seen a reduction of average time as current biologic for etanercept in monotherapy and golimumab in combination therapy.
Disclosure of Interest None declared
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