National registry of biological and targeted therapy of rheumatic diseases ATTRA – 20 years of experience
Authors:
K. Pavelka 1; Z. Křístková 2; L. Dušek 3
Authors place of work:
Revmatologický ústav Praha
1; Institut biostatistiky a analýz, s. r. o., Brno
2; Ústav zdravotnických informací a statistiky ČR, Praha
3
Published in the journal:
Čes. Revmatol., 28, 2020, No. 3, p. 120-131.
Category:
Original article
Summary
The national registry of biological therapy of rheumatic diseases ATTRA was established 20 years ago. A total of 5324 patients diagnosed with rheumatoid arthritis were entered into the registry. The median follow-up is 5 years and the total patient exposure is 27,358 patient-years. The number of patients is increasing and in recent years there has been an annual increase of 621 patients. Analysis of patients at the beginning of the study shows that these are patients with long disease duration, already with significant functional impairment and high activity (DAS 28 ESR 6.3 ± 0.9). At baseline, 63% of patients were using glucocorticoids, and 82% conventional synthetic DMARDs (csDMARD). Adherence to treatment with the first biological drug was 77.4% after 12 months and 63.8% after 24 months. The most common reasons for discontinuation were secondary failure 37.3%, primary failure 28.3%, and adverse events 25.8%. The mean DAS 28 decreased from 6.3 ± 0.9 to 3.1 ± 1.4 after 24 months. Fifty-five % of patients were in low activity or remission after 2 years of treatment. When assessing the quality of life, there was a significant improvement in all aspects assessed by the SF-36 questionnaire. The ability to work has improved significantly as the values of presenteeism and absenteeism assessed using the WPAI questionnaires have improved. The incidence of adverse reactions is in line with international experience. Tuberculosis occurred in only 19 patients.
Conclusion: The ATTRA registry documents the means of treating rheumatoid arthritis with biological drugs in biological treatment centers. The results are very good but show that the T2T principle could be used more intensively in routine clinical practice. The incidence of adverse reactions is lower than in comparable registries, which may be due to insufficient reporting.
Keywords:
rheumatoid arthritis – biological treatment – ATTRA registry
Zdroje
1. Smolen JS, Aletaha D, Bijlsma W, et al. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis 2010; 69: 631–637.
2. Thiele K, Huscher D, Bischoff S, et al. Performance of the 2011 ACR/EULAR preliminary remission criteria compared with DAS 28 remission in unselected patients with rheumatoid arthritis. Ann Rheum Dis 2013; 72: 1194–1199.
3. Mann HF, Závada J, Šenolt L, Bubová K, Nekvindová L, Křístková Z, Horák P, Vencovský P, Pavelka K and the ATTRA Registry. Real world use of secukinumab for treatmentof axial spondyloarthritis and psoriatic arthritis: nationwide results from the ATTRA registry. Clin Exp Rheumatol 2019; 342–343.
4. Pavelka K, Forejtová Š, Štolfa J, Chroust K, Burešová L, Mann H, Vencovský J. Anti-TNF therapy of ankylosing spondylitis in clinical practice. Results from the Czech national registry ATTRA. Clin Exp Rheum 2009; 27: 964–969
5. Horák P, Skácelová M, Hejduk K, Smržová A, Pavelka K. Abatacept and its use in the treatment of rheumatoid artritis in the Czech Republic – data from the ATTRA registry. Clin Rheumatol 2013; 32: 1451–1458.
6. Chatzidionysiou K, Lie E, Nasonov E, et al. Effectiveness of disease-modifying antirheumatic drug co-therapy with methotrexate and leflunomide in rituximab-treated rheumatoid arthritis patients: results of a 1-year follow-up study from the CERERRA collaboration. Ann Rheum Dis 2012; 71: 374–377.
7. Chatzidionysiou K, Lie E, Nasonov E, Lukina G, et al., on behalf of the Rheumatic Disease Portuguese Register. Effectiveness of two different doses of rituximab for the treatment of rheumatoid arthritis in an international cohort: data from the CERERRA collaboration. Arthritis Res Ther 2016. doi:10.1186/s13075-016-0951-z
8. Lauper K, Nordström DC, Pavelka K, Hernández MV, et al. Comparative effectiveness of tocilizumab versus TNF inhibitors as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis after the use of at least one biologic disease-modifying antirheumatic drug: analyses from the pan-European TOCERRA register collaboration. Ann Rheum Dis 2018; 77: 1276–1282.
9. Courvoisier DS, Chatzidionysiou K, Mongin D, et al. The impact of seropozitivity on the effectiveness of biologic antirheumatic agents. Abstrakt EULAR 2018.
10. Finckh A, Neto D, Iannone F, et al. The impact of patient heterogeneity and socioeconomic factors on abatacept retention in rheumatoid arthritis across nine European countries. RMD Open 2015; 1: e000040. doi:10.1136/rmdopen-2014-000040
11. Lauper K, Mongin D, Bergstra SA, et al. Comparative effectiveness of JAK-inhibitors, TNF-inhibitors, abatacept and IL-6 inhibitors in an international collaboration of regisers of rheumatoid arthritis patients (the “JAK-pot” study). Abstrakt EULAR 2020.
12. Reilly Associates, Work Productivity and Activity Impairment Questionnaire: http://www.reillyassociates.net/WPAI General.html
13. Smolen JS, Han C, van der Heide D, et al. Radiographic joint progression in sustained remission is determined by disease activity levels preceding the period of radiographic assessment. Arthritis Rheum 2009; 60: 1242–1249.
14. Kay J, Schoels MM, Dorner T, et al. Consensus – based recommendations for the use of biosimilars to treat Rheumatological diseases. ARD Online first, published October 3,2017 as 10.1136/annrehumdis-2017-211937
15. Agca R, Heslinga C, M Rollefstad S, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorder2015/2016 update Ann Rheum Dis 2017; 76: 17–28.
16. Glintborg G, Loit AG, Omerovic E, et al. To switch or not to switch results of a nationwide guideline of mandatory switching from originator to biosimilar etanercept. One year treatment outcomes in 2061 patients with inflammatory arthritis from the DANBIO registry. Ann Rheum Dis 2018; 0: 1–9. doi:10.1136/annrheumdis-2018-213474
17. van Vollenhoven RF, Fleischmann R, Cohen S. Tofacitinib or adalimumab versus placebo in rheumatoid arthritis. N Engl J Med 2012; 36: 508–519.
18. Taylor PC, Keystone EC, van der Heijde D. et al. Baricitinib versus placebo or adalimumab in rheumatoid arthritis. N Engl J Med 2017; 376: 652–662.
19. Kang EH, Liao KP, Kim SC, et al. Cardiovascular safety of biologics and JAK inhibitors in patients with rheumatoid arthritis. Current Rheumatology Reports 2018; 20: 42. https://doi.org/1007/s1196-018-07522-2
20. Einarson JT, Willim M, Ernestam S, et al. Prevalence of sustained remission in rheumatoid arthritis“ impact of criteria sets and disease duration. A Nationwide study in Sweden. Rheumatology 2019; 58: 227–236.
21. Radner H, Smolen JS, Aletaha D. Remission in rheumatoid arthritis benefit over low disease activity in patients – reported outcomes and costs. Arthritis Research Ther 2014; 16: R56.
Štítky
Dermatology & STDs Paediatric rheumatology RheumatologyČlánok vyšiel v časopise
Czech Rheumatology
2020 Číslo 3
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