Background: Biological disease-modifying antirheumatic drugs (bDMARDs) have made apparent development of treating rheumatoid arthritis (RA). However, prescription of them appeared to be relatively difficult due to high cost. The newest EULAR recommendation advocates tapering of bDMARDs when RA activity is controlled.

Objectives: A multicenter clinical study on a longer interval treatment with three bDMARDs, Golimumab (GOL), which is one of TNF inhibitors, and two of non-TNF inhibitor, Tocilizumab (TCZ) and Abatacept (ABT) was investigated.

Methods: Patients, who were maintained at low disease activity by DAS28 score for more than 3 months treated with GLM, TCZ, ABT, were enrolled. These selected patients were treated with these drugs with 1.5 fold longer interval of standard schedule for 60 weeks, and the rate of patients, who preserved low disease activity were determined. The patients who were not tolerated these drugs because of the side effects or adverse events, were withdrawn from this study.

Results: One hundred thirty-one patients treated with GLM, 149 with ABT (S.C. 61, I.V. 88) and 299 with TCZ (S.C. 87, I.V. 212) were enrolled. Among these, 57 patients treated with GLM (43%), 40 with ABT(26%, S.C 18, I.V 22), 93 with TCZ (31%, S.C 21, I.V 72) were successfully maintained at low disease activity with this 1.5 folds longer interval treatment, respectively. The age of patients in ABT group was 73.5±10.6, and significantly higher than those in TCZ (58.8±13.9) and GOL (58.1±14.7) groups. At 60 weeks, DAS28 in ABT group was 3.1±0.5, and significantly higher than those in TCZ (2.6±0.7) and GLM (2.6±0.7) groups. On the other hand, CDAI in GOL was 6.6±3.4, and was significantly higher than those in TCZ (4.4±2.6) or ABT (4.6±2.3) groups. Accordingly, successive rate at 60th week in ABT group was 52% and significantly lower than those in TCZ (69%) or in GOL (73%) groups as shown in figure. Finally, no significant difference in successive rate was observed between s.c. and i.v.

Conclusions: This study clarified that TCZ and GLM had higher successive rate than ABT for maintaining low disease activity for 60 weeks by longer interval treatment. This effectiveness might relate to the high therapeutic efficacy of TCZ and low antigenicity of GOL.

Disclosure of Interest: None declared