Skip to main content
Top
Published in: Modern Rheumatology 3/2013

01-05-2013 | Original Article

Twenty-four-week clinical results of adalimumab therapy in Japanese patients with rheumatoid arthritis: retrospective analysis for the best use of adalimumab in daily practice

Authors: Atsushi Kaneko, Yuji Hirano, Takayoshi Fujibayashi, Yosuke Hattori, Kenya Terabe, Toshihisa Kojima, Naoki Ishiguro

Published in: Modern Rheumatology | Issue 3/2013

Login to get access

Abstract

Objective

We evaluated patient drug adherence to and efficacy and safety of adalimumab (ADA) based on data collected from approximately 200 patients to retrospectively examine the best use of ADA in Japanese patients with longstanding rheumatoid arthritis (RA) managed in daily practice.

Methods

For explorative comparisons, patients were stratified by prior use or no use of biologics (Bio-naïve vs. Bio-switch) and concomitant use (+) or no use (−) of methotrexate (MTX) into four subgroups. The primary efficacy endpoint was extent of improvement in the Disease Activity Score in 28 joints using erythrocyte sedimentation rate (DAS28-ESR) from baseline to 24 weeks assessed as European League Against Rheumatism (EULAR) good response. Secondary endpoints included ADA treatment continuation as represented by Kaplan–Meier survival curves and percentages of patients achieving remission as defined by DAS28-ESR <2.6.

Results

Overall, mean DAS28-ESR significantly decreased from 5.6 ± 1.2 at baseline to 4.1 ± 1.7 at week 24 (p < 0.0001), and >30 % of patients achieved EULAR good response. Subgroup analyses indicated that patients in the Bio-naïve and MTX (+) subgroup showed the highest EULAR good response rate of 37.3 % at week 24. The three most commonly reported adverse events (AEs) were skin allergies such as injection-site reactions, infections, and respiratory disorders such as interstitial lung lesions and organizing pneumonia.

Conclusion

In conclusion, ADA therapy resulted in significant clinical response in established Japanese patients with RA treated in daily practice. It also demonstrated generally good safety and tolerability. It was suggested that the best use of ADA may be in biologically naïve patients with concomitant administration of MTX.
Literature
1.
go back to reference Hochberg MC, Lebwohl MG, Plevy SE, Hobbs KF, Yocum DE. The benefit/risk profile of TNF-blocking agents: findings of a consensus panel. Semin Arthritis Rheum. 2005;34:819–36.PubMedCrossRef Hochberg MC, Lebwohl MG, Plevy SE, Hobbs KF, Yocum DE. The benefit/risk profile of TNF-blocking agents: findings of a consensus panel. Semin Arthritis Rheum. 2005;34:819–36.PubMedCrossRef
2.
go back to reference Vultaggio A, Matucci A, Nencini F, Pratesi S, Parronchi P, Rossi O, et al. Anti-infliximab IgE and non-IgE antibodies and induction of infusion-related severe anaphylactic reactions. Allergy. 2010;65:657–61.PubMedCrossRef Vultaggio A, Matucci A, Nencini F, Pratesi S, Parronchi P, Rossi O, et al. Anti-infliximab IgE and non-IgE antibodies and induction of infusion-related severe anaphylactic reactions. Allergy. 2010;65:657–61.PubMedCrossRef
3.
go back to reference Weinblatt ME, Keystone EC, Furst DE, Moreland LW, Weisman MH, Birbara CA, et al. Adalimumab, a fully human anti-tumor necrosis factor α monoclonal antibody, for treating rheumatoid arthritis in patients taking concomitant methotrexate: the ARMADA trial. Arthritis Rheum. 2003;48:35–45.PubMedCrossRef Weinblatt ME, Keystone EC, Furst DE, Moreland LW, Weisman MH, Birbara CA, et al. Adalimumab, a fully human anti-tumor necrosis factor α monoclonal antibody, for treating rheumatoid arthritis in patients taking concomitant methotrexate: the ARMADA trial. Arthritis Rheum. 2003;48:35–45.PubMedCrossRef
4.
go back to reference Keystone EC, Kavanaugh AF, Sharp JT, Tannenbaum H, Hua Y, Teoh LS, et al. Radiographic, clinical and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: a randomized, placebo-controlled, 52-week trial. Arthritis Rheum. 2004;50:1400–11.PubMedCrossRef Keystone EC, Kavanaugh AF, Sharp JT, Tannenbaum H, Hua Y, Teoh LS, et al. Radiographic, clinical and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: a randomized, placebo-controlled, 52-week trial. Arthritis Rheum. 2004;50:1400–11.PubMedCrossRef
5.
go back to reference Breedveld FC, Weisman MH, Kavanaugh AF, Cohen SB, Pavelka K, van Vollenhoven R, et al. A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment. Arthritis Rheum. 2006;54:26–37.PubMedCrossRef Breedveld FC, Weisman MH, Kavanaugh AF, Cohen SB, Pavelka K, van Vollenhoven R, et al. A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment. Arthritis Rheum. 2006;54:26–37.PubMedCrossRef
6.
go back to reference Weinblatt ME, Keystone EC, Furst DE, Kavanaugh AF, Chartash EK, Segurado OG. Long term efficacy and safety of adalimumab plus methotrexate in patients with rheumatoid arthritis: ARMADA 4 year extended study. Ann Rheum Dis. 2006;65:753–9.PubMedCrossRef Weinblatt ME, Keystone EC, Furst DE, Kavanaugh AF, Chartash EK, Segurado OG. Long term efficacy and safety of adalimumab plus methotrexate in patients with rheumatoid arthritis: ARMADA 4 year extended study. Ann Rheum Dis. 2006;65:753–9.PubMedCrossRef
7.
go back to reference Bejarano V, Quinn M, Conaghan PG, Reece R, Keenan A-N, Walker D, et al. Effect of the early use of the anti-tumor necrosis factor adalimumab on the prevention of job loss in patients with early rheumatoid arthritis. Arthritis Rheum. 2008;59:1467–74.PubMedCrossRef Bejarano V, Quinn M, Conaghan PG, Reece R, Keenan A-N, Walker D, et al. Effect of the early use of the anti-tumor necrosis factor adalimumab on the prevention of job loss in patients with early rheumatoid arthritis. Arthritis Rheum. 2008;59:1467–74.PubMedCrossRef
8.
go back to reference Van Vollenhoven RF, Cifaldi MA, Ray S, Chen N, Weisman MH. Improvement in work place and household productivity for patients with early rheumatoid arthritis treated with adalimumab plus methotrexate: work outcomes and their correlations with clinical and radiographic measures from a randomized controlled trial comparison study. Arthritis Care Res. 2010;62:226–34.CrossRef Van Vollenhoven RF, Cifaldi MA, Ray S, Chen N, Weisman MH. Improvement in work place and household productivity for patients with early rheumatoid arthritis treated with adalimumab plus methotrexate: work outcomes and their correlations with clinical and radiographic measures from a randomized controlled trial comparison study. Arthritis Care Res. 2010;62:226–34.CrossRef
9.
go back to reference Kojima T, Kaneko A, Hirano Y, Ishikawa H, Miyake H, Oguchi T, et al. Study protocol of a multicenter registry of patients with rheumatoid arthritis starting biologic therapy in Japan: Tsurumai Biologics Communication Registry (TBCR) Study. Mod Rheumatol. 2011;. doi:10.1007/s10165-011-0518-4. Kojima T, Kaneko A, Hirano Y, Ishikawa H, Miyake H, Oguchi T, et al. Study protocol of a multicenter registry of patients with rheumatoid arthritis starting biologic therapy in Japan: Tsurumai Biologics Communication Registry (TBCR) Study. Mod Rheumatol. 2011;. doi:10.​1007/​s10165-011-0518-4.
11.
go back to reference Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31:315–24.PubMedCrossRef Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31:315–24.PubMedCrossRef
12.
go back to reference Saag KG, Teng GG, Patkar NM, Anuntiyo J, Finney C, Curtis JR, et al. American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum. 2008;59:762–84.PubMedCrossRef Saag KG, Teng GG, Patkar NM, Anuntiyo J, Finney C, Curtis JR, et al. American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum. 2008;59:762–84.PubMedCrossRef
13.
go back to reference Van Gestel AM, Haagsma CJ, van Riel PLCM. Validation of rheumatoid arthritis improvement criteria that include simplified joint counts. Arthritis Rheum. 1998;41:1845–50.PubMedCrossRef Van Gestel AM, Haagsma CJ, van Riel PLCM. Validation of rheumatoid arthritis improvement criteria that include simplified joint counts. Arthritis Rheum. 1998;41:1845–50.PubMedCrossRef
14.
go back to reference Van Gestel AM, Anderson JJ, van Riel PL, Boers M, Haagsma CJ, Rich B, et al. ACR and EULAR improvement criteria have comparable validity in rheumatoid arthritis trials. American College of Rheumatology European League of Associations for Rheumatology. J Rheumatol. 1999;26:705–11. Van Gestel AM, Anderson JJ, van Riel PL, Boers M, Haagsma CJ, Rich B, et al. ACR and EULAR improvement criteria have comparable validity in rheumatoid arthritis trials. American College of Rheumatology European League of Associations for Rheumatology. J Rheumatol. 1999;26:705–11.
15.
go back to reference Shinomiya F, Mima N, Nanba K, Tani K, Nakano S, Egawa H, et al. Life expectancies of Japanese patients with rheumatoid arthritis: a review of deaths over a 20-year period. Mod Rheumatol. 2008;18:165–9.PubMedCrossRef Shinomiya F, Mima N, Nanba K, Tani K, Nakano S, Egawa H, et al. Life expectancies of Japanese patients with rheumatoid arthritis: a review of deaths over a 20-year period. Mod Rheumatol. 2008;18:165–9.PubMedCrossRef
16.
go back to reference Van der Heijde D, Breedveld FC, Kavanaugh A, Keystone EC, Landewe R, Patra K, et al. Disease activity, physical function, and radiographic progression after long-term therapy with adalimumab plus methotrexate: 5-year results of PREMIER. J Rheumatol. 2010;37:2237–46.PubMedCrossRef Van der Heijde D, Breedveld FC, Kavanaugh A, Keystone EC, Landewe R, Patra K, et al. Disease activity, physical function, and radiographic progression after long-term therapy with adalimumab plus methotrexate: 5-year results of PREMIER. J Rheumatol. 2010;37:2237–46.PubMedCrossRef
17.
go back to reference Keystone EC, Kavanaugh A, Weinblatt ME, Patra K, Pangan AL. Clinical consequences of delayed addition of adalimumab to methotrexate therapy over 5 years in patients with rheumatoid arthritis. 2011. doi:10.3899/jrheum.100752. Keystone EC, Kavanaugh A, Weinblatt ME, Patra K, Pangan AL. Clinical consequences of delayed addition of adalimumab to methotrexate therapy over 5 years in patients with rheumatoid arthritis. 2011. doi:10.​3899/​jrheum.​100752.
18.
go back to reference Miyasaka N, the CHANGE study Investigators. Clinical investigation in highly disease-affected rheumatoid arthritis patients in Japan with adalimumab applying standard and general evaluation: the CHANGE study. Mod Rheumatol. 2008;18:252–62.PubMedCrossRef Miyasaka N, the CHANGE study Investigators. Clinical investigation in highly disease-affected rheumatoid arthritis patients in Japan with adalimumab applying standard and general evaluation: the CHANGE study. Mod Rheumatol. 2008;18:252–62.PubMedCrossRef
19.
go back to reference Bartelds GM, Wijbrandts CA, Nurmohamed MT, Stapel S, Lems WF, Aarden L, et al. Clinical response to adalimumab: relationship to anti-adalimumab antibodies and serum adalimumab concentrations in rheumatoid arthritis. Ann Rheum Dis. 2007;66:921–6.PubMedCrossRef Bartelds GM, Wijbrandts CA, Nurmohamed MT, Stapel S, Lems WF, Aarden L, et al. Clinical response to adalimumab: relationship to anti-adalimumab antibodies and serum adalimumab concentrations in rheumatoid arthritis. Ann Rheum Dis. 2007;66:921–6.PubMedCrossRef
20.
go back to reference Radstake TRDJ, Svenson M, Eijsbouts AM, van den Hoogen FHJ, Enevold C, van Riel PLCM, et al. Formation of antibodies against infliximab and adalimumab strongly correlated with functional drug levels and clinical response in rheumatoid arthritis. Ann Rheum Dis. 2009;68:1739–45.PubMedCrossRef Radstake TRDJ, Svenson M, Eijsbouts AM, van den Hoogen FHJ, Enevold C, van Riel PLCM, et al. Formation of antibodies against infliximab and adalimumab strongly correlated with functional drug levels and clinical response in rheumatoid arthritis. Ann Rheum Dis. 2009;68:1739–45.PubMedCrossRef
21.
go back to reference Kaneko A. Case reports of biological products: D. Adalimumab. In: Abe C, Kondo M, Matsubara T, Yamasaki K. Nihon Igakukan, editors. The manual of rheumatoid arthritis therapy with biologics. 2010; 69–77. Kaneko A. Case reports of biological products: D. Adalimumab. In: Abe C, Kondo M, Matsubara T, Yamasaki K. Nihon Igakukan, editors. The manual of rheumatoid arthritis therapy with biologics. 2010; 69–77.
22.
go back to reference Kievit W, Adang EM, Fransen J, Kuper HH, van de Laar MAFJ, Jansen TL, et al. The effectiveness and medication costs of three anti-tumor necrosis factor agents in treating rheumatoid arthritis from prospective clinical practice data. Ann Rheum Dis. 2008;67:1229–34.PubMedCrossRef Kievit W, Adang EM, Fransen J, Kuper HH, van de Laar MAFJ, Jansen TL, et al. The effectiveness and medication costs of three anti-tumor necrosis factor agents in treating rheumatoid arthritis from prospective clinical practice data. Ann Rheum Dis. 2008;67:1229–34.PubMedCrossRef
23.
go back to reference Hetland ML, Christensen IJ, Tarp U, Dreyer L, Hansen A, Hansen IT, et al. Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry. Arthritis Rheum. 2010;62:22–32.PubMedCrossRef Hetland ML, Christensen IJ, Tarp U, Dreyer L, Hansen A, Hansen IT, et al. Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry. Arthritis Rheum. 2010;62:22–32.PubMedCrossRef
24.
go back to reference Du Pan SM, Dehler S, Ciurea A, Ziswiler H-R, Gabay C, Finckh A. Comparison of drug retention rates and causes of drug discontinuation between anti-tumor necrosis factor agents in rheumatoid arthritis. Arthritis Rheum. 2009;61:560–8.PubMedCrossRef Du Pan SM, Dehler S, Ciurea A, Ziswiler H-R, Gabay C, Finckh A. Comparison of drug retention rates and causes of drug discontinuation between anti-tumor necrosis factor agents in rheumatoid arthritis. Arthritis Rheum. 2009;61:560–8.PubMedCrossRef
25.
go back to reference Gomez-Reino JJ, Garmona L. Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period. Arthritis Res Ther. 2006;8:R29–35.PubMedCrossRef Gomez-Reino JJ, Garmona L. Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period. Arthritis Res Ther. 2006;8:R29–35.PubMedCrossRef
26.
go back to reference Smolen JS, Landewé R, Breedveld FC, Dougados M, Emery P, Gaujoux-Viala C, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis. 2010;69:964–75.PubMedCrossRef Smolen JS, Landewé R, Breedveld FC, Dougados M, Emery P, Gaujoux-Viala C, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis. 2010;69:964–75.PubMedCrossRef
27.
go back to reference Humira® (adalimumab) (prescribing information). Abbott Laboratories. North Chicago; 2010. Humira® (adalimumab) (prescribing information). Abbott Laboratories. North Chicago; 2010.
28.
go back to reference Paltiel M, Gober LM, Deng A, Mikdashi J, Alexeeva I, Saini SS, et al. Immediate type I hypersensitivity response implicated in worsening injection site reactions to adalimumab. Arch Dermatol. 2008;144:1190–4.PubMedCrossRef Paltiel M, Gober LM, Deng A, Mikdashi J, Alexeeva I, Saini SS, et al. Immediate type I hypersensitivity response implicated in worsening injection site reactions to adalimumab. Arch Dermatol. 2008;144:1190–4.PubMedCrossRef
29.
go back to reference Benucci M, Manfredi M, Demoly P, Campi P. Injection site reactions to TNF-α blocking agents with positive skin tests. Allergy. 2008;63:138–9.PubMedCrossRef Benucci M, Manfredi M, Demoly P, Campi P. Injection site reactions to TNF-α blocking agents with positive skin tests. Allergy. 2008;63:138–9.PubMedCrossRef
30.
go back to reference Smolen JS, Aletaha D, Koeller M, Weisman MH, Emery P. New therapies for treatment of rheumatoid arthritis. Lancet. 2007;370:1861–74.PubMedCrossRef Smolen JS, Aletaha D, Koeller M, Weisman MH, Emery P. New therapies for treatment of rheumatoid arthritis. Lancet. 2007;370:1861–74.PubMedCrossRef
Metadata
Title
Twenty-four-week clinical results of adalimumab therapy in Japanese patients with rheumatoid arthritis: retrospective analysis for the best use of adalimumab in daily practice
Authors
Atsushi Kaneko
Yuji Hirano
Takayoshi Fujibayashi
Yosuke Hattori
Kenya Terabe
Toshihisa Kojima
Naoki Ishiguro
Publication date
01-05-2013
Publisher
Springer Japan
Published in
Modern Rheumatology / Issue 3/2013
Print ISSN: 1439-7595
Electronic ISSN: 1439-7609
DOI
https://doi.org/10.1007/s10165-012-0705-y

Other articles of this Issue 3/2013

Modern Rheumatology 3/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine