Background Tocilizumab (TCZ) is effective for rheumatoid arthritis (RA) patients with inadequate responses to tumor necrosis factor (TNF) antagonists. Previous report showed that among RA patients who were switched to a second TNF antagonist, the reasons for stopping a second drug were related to the reasons for stopping the first drug¹. However, it has not yet been established whether the type of failure that motivated the switch from TNF antagonists influences the retention of TCZ.

Objectives The present study was undertaken to investigate the relationship between the retention of TCZ and the reason for discontinuation of previous TNF antagonists in RA patients.

Methods This study included 191 RA patients who switched from TNF antagonists to TCZ therapy in Tsurumai Biologics Communication Registry (TBCR). The retention rates of TCZ at 2 years were calculated by the Kaplan-Meier method and compared using the log-rank test between two groups divided by the reasons for discontinuation of previous TNF antagonists (162 patients with inefficacy; LOE group, and 29 patients with adverse events; AE group).

Results There were no differences between the two groups in terms of age, disease duration, TNF antagonist before switch, concomitant MTX use, or DAS28-ESR at the switch to TCZ therapy. The discontinuation rate of TCZ at 2 years in LOE group was significantly lower compared with AE group (p=0.023, log-rank test). No significant differences existed between the two groups for treatment discontinuation due to inefficacy (p=0.476). On the other hand, the discontinuation rate due to adverse events was significantly lower for LOE group compared with AE group (p=0.001).

Conclusions RA patients who switched from TNF antagonists due to inefficacy to TCZ have high rates of continuation.

References

1. Hyrich KL, et al. Outcomes after switching from one anti-tumor necrosis factor alpha agent to a second anti-tumor necrosis factor alpha agent in patients with rheumatoid arthritis: results from a large UK national cohort study. Arthritis Rheum. 2007 Jan;56(1):13-20.

Disclosure of Interest N. Asai: None declared, Y. Yabe: None declared, T. Kojima Grant/research support from: Takeda Pharma Corporation, Janssen Pharmaceutical, and Astellas Pharma Corporation., Speakers bureau: Mitsubishi Tanabe Pharma Corporation, Takeda Pharma Corporation, Eisai Pharma Corporation, Abbvie, Bristol-Myers Squibb, Pfizer, Chugai Pharma Corporation, Janssen Pharmaceutical, and Astellas Pharma Corporation., N. Takahashi: None declared, K. Funahashi: None declared, S. Asai Speakers bureau: Eisai Pharma Corporation., T. Takemoto: None declared, K. Terabe: None declared, Y. Yoshioka: None declared, N. Ishiguro Grant/research support from: Daiichi Sankyo, Takeda Pharmaceutical, Hisamitsu Pharmaceutical, Otsuka Pharmaceutical, Taisho Toyama Pharmaceutical, Kaken Pharmaceutical, Eisai, Janssen Pharmaceutical, Bristol-Myers Squibb, Abbott Japan, Chugai Pharmaceutical, Mitsubishi Tanabe Pharmaceutical, Astellas Pharma, and Pfizer Japan., Speakers bureau: Daiichi Sankyo, Takeda Pharmaceutical, Hisamitsu Pharmaceutical, Otsuka Pharmaceutical, Taisho Toyama Pharmaceutical, Kaken Pharmaceutical, Eisai, Janssen Pharmaceutical, Bristol-Myers Squibb, Abbott Japan, Chugai Pharmaceutical, Mitsubishi Tanabe Pharmaceutical, Astellas Pharma, and Pfizer Japan.