Survival of bDMARDs in bionaive patients with rheumatoid arthritis: data from a retrospective 12-month follow-up

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Abstract

Aim. Analysis of survival on biological therapy in previously bionaive patients with rheumatoid arthritis (RA) during the first year of therapy in real clinical practice.

Materials and methods. The retrospective study included 204 adult patients with RA. In the hospital, patients were first prescribed therapy with various biological disease-modifying antirheumatic drugs (bDMARDs): infliximab, adalimumab, etanercept, certolizumab pegol, tocilizumab, abatacept (ABA), rituximab (RTM). Patients were divided by age in accordance with the classification adopted by WHO. Clinical forms of RA were presented: RA, seropositive for rheumatoid factor, RA, seronegative for rheumatoid factor, RA with extra-articular manifestations, adult-oneset Still’s disease, juvenile RA. The reasons for the cancellation of bDMARD during the first year of treatment were: insufficient effectiveness (including primary inefficiency), adverse events, administrative reasons, clinical and laboratory remission, death.

Results. A year after being included in the study, treatment was continued in 92 (45%) patients and was discontinued in 112 patients. The average time of treatment amounted to 0.75±0.33 years. The longest duration of treatment was in the RTM and ABA groups (0.92±0.22 and 0.83±0.29 years, respectively). In 56 (50%) patients, bDMARD was canceled due to insufficient effectiveness (including primary inefficiency), 28 patients (25%) – due to the development of adverse reactions, 19 (17%) patients – for administrative reasons, 7 (6.25%) patients – due to drug remission. During the first year of therapy, there were 2 (1.75%) deaths due to severe comorbid conditions in patients, one of whom received RTM, the other – tocilizumab.

Conclusion. Study showed that 45% of patients with RA continue treatment with first-time bDMARD for more than 12 months. The most common reason for discontinuation of therapy was its lack of effectiveness. The best survival rate of bDMARDs was observed in RTM and ABA. When selecting bDMARD in each case, it is necessary to take into account the continuity at all stages of treatment.

About the authors

E. S. Aronova

Nasonova Research Institute of Rheumatology

Author for correspondence.
Email: eugpozd@mail.ru
ORCID iD: 0000-0002-1833-5357

к.м.н., науч. сотр. лаб. изучения коморбидных инфекций и мониторинга безопасности лекарственной терапии

Russian Federation, Moscow

G. V. Lukina

Loginov Moscow Clinical Scientific Center; Nasonova Research Institute of Rheumatology

Email: eugpozd@mail.ru
ORCID iD: 0000-0001-7958-5926

д.м.н., проф., вед. науч. сотр. лаб. изучения коморбидных инфекций и мониторинга безопасности лекарственной терапии

Russian Federation, Moscow

S. I. Glukhova

Nasonova Research Institute of Rheumatology

Email: eugpozd@mail.ru
ORCID iD: 0000-0002-4285-0869

к.б.н., ст. науч. сотр. лаб. медико-социальных проблем ревматологии

Russian Federation, Moscow

G. I. Gridneva

Nasonova Research Institute of Rheumatology

Email: eugpozd@mail.ru
ORCID iD: 0000-0002-0928-3911

к.м.н., науч. сотр. лаб. изучения коморбидных инфекций и мониторинга безопасности лекарственной терапии

Russian Federation, Moscow

A. V. Kudryavtseva

Nasonova Research Institute of Rheumatology

Email: eugpozd@mail.ru
ORCID iD: 0000-0001-8159-432X

науч. сотр. лаб. изучения коморбидных инфекций и мониторинга безопасности лекарственной терапии

Russian Federation, Moscow

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