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01-07-2021 | Sarilumab | Original Article

Drug retention of sarilumab, baricitinib, and tofacitinib in patients with rheumatoid arthritis: the ANSWER cohort study

Authors: Kosuke Ebina, Toru Hirano, Yuichi Maeda, Wataru Yamamoto, Motomu Hashimoto, Koichi Murata, Akira Onishi, Sadao Jinno, Ryota Hara, Yonsu Son, Hideki Amuro, Tohru Takeuchi, Ayaka Yoshikawa, Masaki Katayama, Keiichi Yamamoto, Makoto Hirao, Yasutaka Okita, Atsushi Kumanogoh, Ken Nakata

Published in: Clinical Rheumatology | Issue 7/2021

Abstract

Objectives

The aim of this multicenter, retrospective study was to clarify the retention rates of sarilumab (SAR), baricitinib (BAR), and tofacitinib (TOF) in patients with rheumatoid arthritis (RA).

Methods

Patients treated with either SAR (n = 62), BAR (n = 166), or TOF (n = 185) (females, 80.9%; age, 61.0 years; disease duration, 11.1 years; rheumatoid factor positivity, 84.4%; Disease Activity Score in 28 joints using erythrocyte sedimentation rate, 4.3; concomitant prednisolone dose, 5.3 mg/day [47.0%] and methotrexate dose, 8.8 mg/week [58.4%]; biologics- or Janus kinase inhibitors-switched cases 78.4%) were included. The reasons for drug discontinuation were classified into 4 major categories (lack of effectiveness, toxic adverse events, non-toxic reasons, and remission) by each attending physician. The drug retention rate was estimated at 18 months using the Kaplan–Meier method and adjusted for potential confounders by Cox proportional hazards modeling.

Results

The discontinuation rates of SAR, BAR, and TOF for the corresponding reasons were as follows, respectively: lack of effectiveness (15.7%, 15.6%, and 21.5%; P = 0.84), toxic adverse events (15.8%, 12.1%, and 12.3%; P = 0.35), non-toxic reasons (10.9%, 7.7%, and 6.8%; P = 0.35), and remission (0.0%, 2.8%, and 0.0%; P = 1.0). The overall retention rates excluding non-toxic reasons and remission were as follows: 68.8% for SAR, 72.5% for BAR, and 66.7% for TOF (P = 0.54).

Conclusions

After adjustment by potent confounders, SAR, BAR, and TOF showed similar discontinuation rates due to lack of effectiveness and toxic adverse events.

Key Points

• This is the first retrospective multicenter study that aimed to clarify the retention rates and reasons for discontinuation of SAR, BAR, and TOF in patients with RA.

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Title: Drug retention of sarilumab, baricitinib, and tofacitinib in patients with rheumatoid arthritis: the ANSWER cohort study
Authors: Kosuke Ebina
Toru Hirano
Yuichi Maeda
Wataru Yamamoto
Motomu Hashimoto
Koichi Murata
Akira Onishi
Sadao Jinno
Ryota Hara
Yonsu Son
Hideki Amuro
Tohru Takeuchi
Ayaka Yoshikawa
Masaki Katayama
Keiichi Yamamoto
Makoto Hirao
Yasutaka Okita
Atsushi Kumanogoh
Ken Nakata
Publication date: 01-07-2021
Publisher: Springer International Publishing
Keywords: Sarilumab
Methotrexate
Methotrexate
Rheumatoid Arthritis
Prednisolone
Published in: Clinical Rheumatology / Issue 7/2021
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-021-05609-7

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