Background When using biological agents, particularly tumor necrosis factor (TNF) inhibitors, in patients with rheumatoid arthritis (RA), the use of methotrexate (MTX) or prednisolone (PSL) can cause considerable problems for patients because they cause adverse events. Therefore, safety would be increased if MTX and PSL could be tapered or stopped. The objective of this report was to determine the drug retention rate of golimumab (GLM) in Japanese patients with RA and identify potential predictors associated with treatment discontinuation.

Methods A prospective analysis was performed on 152 patients with RA who were treated with GLM in our multicenter biologics registry. We assessed the age, body weight, disease duration, use of pre-biological agents, Disease Activity Score 28-Erythrocyte Sedimentation Rate, and use and dose of MTX and PSL as baseline characteristics of the patients, and we compared cumulative survival among these factors.

Results The overall 52 weeks drug survival rate of GLM was 71.6%. The patients with a body weight of <50 kg had a better drug survival rate than those with a body weight of >50kg (see Table). The use and dose of MTX and use of PSL did not show statistical differences in drug survival rate (see Table).

Conclusions In daily practice, patients with RA taper or stop their MTX or PSL use while undergoing treatment with biological agents if their RA disease activities are low. On the other hand, MTX with biological agents, particularly TNF inhibitors, would produce better efficacy than higher dose. Our result indicates that Japanese patients with RA receiving GLM may be able to taper or stop MTX and PSL use, which could increase safety and raise the drug retention rate in these patients. These data would be of value in selecting biological agents for MTX-intolerant RA patients.

Disclosure of Interest None declared