BIOLOGIC DISCONTINUATION IN RHEUMATOID ARTHRITIS- EXPERIENCE FROM CANADIAN CLINICS
Author(s)
Choquette D1, Coupal L1, Laliberté M2, Desjardins O2
1Institut de Rhumatologie de Montréal, Montreal, QC, Canada, 2AbbVie, Saint-Laurent, QC, Canada
OBJECTIVES: The purpose of this study was to describe biologic discontinuation and assess the predictors of discontinuation in Canadian rheumatoid arthritis (RA) patients. METHODS: In this prospective cohort study, adult patients included in the RHUMADATA database with a diagnosis of RA and treated with at least one biologic since 2003 were selected. The RHUMADATA database includes clinical, laboratory and socioeconomic information of patients with rheumatic diseases followed in three Canadian rheumatology centers (Montreal, Quebec and Rimouski). Patients were followed for three years after therapy initiation or until treatment discontinuation, as measured using pharmacy records. Time to discontinuation and predictors of treatment discontinuation were explored using Cox proportional hazards models. RESULTS: A total of 623 eligible patients were treated with at least one biologic. The average age was 53.2 years (SD=12.4), 77% were women and patients had been diagnosed for an average of 7.7 years. The average time on treatment for the first biologic agent was 1.7 years (SD=2.1). In all, 233 (37%), 326 (52%), 405 (65%), and 438 (70%) patients had stopped their first biologic after 6, 12, 24, and 36 months, respectively. In time-to-event analyses (Cox proportional hazard models), type of work [part time vs. full time; hazard ratio (HR): 1.57; 95% confidence interval (CI): 1.05-2.34] and income [$20,000 to $40,000 vs. less than $20,000 (HR: 1.35; 1.01-1.80) and $80,000 to $100,000 vs. less than $20,000 (HR: 2.16; 1.23-3.80)] were significantly associated with biologic discontinuation over the complete treatment duration. The number of disease-modifying antirheumatic drugs used (HR: 0.89; 0.80-0.99) and use of methotrexate (yes vs. no; HR: 0.80; 0.64-0.99) were associated with a reduced risk of biologic discontinuation. CONCLUSIONS: In this real-life Canadian study, high biologic discontinuation rates were observed. This study also suggests that many clinical and socioeconomic variables are predictors of biologic discontinuation in RA patients.
Conference/Value in Health Info
2015-05, ISPOR 2015, Philadelphia, PA, USA
Value in Health, Vol. 18, No. 3 (May 2015)
Code
PMS60
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance
Disease
Musculoskeletal Disorders