Long-term  results of treatment of rheumatoid arthritis with adalimumab in the national ATTRA registry

Česká verzia

Authors: K. Pavelka ¹; L. Nekvindová ²; Z. Křístková ²
Authors place of work: Revmatologický ústav, Praha ¹; Institut biostatistiky a analýz, Brno ²
Published in the journal: Čes. Revmatol., 26, 2018, No. 4, p. 153-161.
Category: Original article

Summary

Rheumatoid arthritis (RA) is a chronic disease, and therefore it is very important that you can administer the biological therapy for a long time. Therefore, so-called survival on biological treatment is observed, especially in the biological treatment registries.

The aim of the work:

To analyze the 10-year survival on adalimumab treatment and evaluate the reasons for its termination. Another objective was to evaluate predictive factors at the start of treatment for possible cessation of treatment.

Methodology:

All patients, who were enrolled in the ATTRA National Registry who met the criteria of the Czech Society fo Rheumatology for biological treatment, were included. Demographic characteristics as well as the main indicators of disease activity, such as DAS28, HAQ and EuroQuol, were assessed. Reasons for discontinuation of treatment were evaluated as primary treatment failure, secondary treatment failure and discontinuation for adverse reactions. Only patients, who were treated with adalimumab as the first biological drug and who were treated during 2003-2017, were analyzed.

Results:

In total 1598 patients with an average disease duration of 10 years and an average DAS28 at baseline of 5.7 ± 0.9 were enrolled. After 10 years of treatment, 27.7% of patients were still treated with adalimumab, the median survival was 43.9 months. The reason for treatment discontinuation was most often the loss of effect at 30.5 %, primary failure at 24.9 % and adverse events at 19.8 %. The predictive factors for longer survival were <50 years versus> 50 years (p = 0.027), maximum failure of 1 csDMARD versus 2 or more in the past (p <0.001), and combination of adalimumab with csDMARD versus monotherapy (p <0.001). Median drug survival was the longest in ankylosing spondylitis, followed by psoriatic arthritis and the shortest in rheumatoid arthritis.

Conclusion:

Adherence to treatment with adalimumab is very good and is 27.7 % after 10 years of treatment. Of the patients still on treatment, 78 % have low activity or remission. Treatment was well tolerated and no new signs of toxicity occurred.

Key words:

adalimumab, rheumatoid arthritis, registry

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