Categories
Change Password!
Reset Password!
Age,
infectious risk, number and type of comorbidities, and monotherapy significantly
affects the preference of abatacept or tocilizumab.
The biologic disease modifying anti-rheumatic drug (bDMARD)
choosen for rheumatoid arthritis (RA) is
mainly dependent on the clinician’s preference as mentioned in the
international recommendations. The real-life factors influencing the first-line
choice or the switching strategy were investigated were investigated which
pivoted on the prescription of abatacept (ABA) or tocilizumab (TCZ) compared to
TNFα inhibitors (TNFi).
A total of 1910 patients registered in the Lombardy Rheumatology Network (LORHEN)
Registry after January 1, 2010 were included when all considered bDMARD agents
were available. The population was classified into “first-” (n = 1264 ) and
“second-line” ( n = 646)
bDMARD. Age was higher in ABA or TCZ vs TNFi treated patients (p < 0.0001).
Positive latent tuberculosis screening was concerned with first-line ABA (p = 0.002). In the
TCZ group (p = 0.02),
methotrexate (MTX) combination therapy was lower. The choice towards ABA (p = 0.01) was
motivated by the type (dyslipidemia, hypertension, pulmonary disease) and the
number of comorbidities.
Second-line treatment, higher age, dyslipidemia, pulmonary
disease, other comorbidities, and extra-articular RA manifestations were concerned
with ABA compared to TNFi as revealed by the multinomial logistic regression.
TCZ was concerned with a second-line treatment, higher age, and more severe
disease activity. The choice towards ABA was influenced by hindering the first
bDMARD due to adverse events (AE). Higher age and comorbidities affect the
choice towards ABA and TCZ as compared to TNFi in the real life. In case of
suspension of earlier treatments due to AE, ABA was considered. After failing a
first-line TNFi, switching to a distinct mechanism of action is more frequent.
Clinical Rheumatology
Factors influencing the choice of first- and second-line biologic therapy for the treatment of rheumatoid arthritis: real-life data from the Italian LORHEN Registry
Sara Monti et al.
Comments (0)