At 6 months and 1 year, respectively, survival rates among the suboptimal responders who stayed on their index anti–tumor necrosis factor (anti-TNF) agent were 90.2% and 85.1%, respectively.
Using anti—tumor necrosis factor (anti-TNF) agents in the treatment of axial spondyloarthritis (axSpA) is associated with good efficacy and improvements in pain, disease activity, and physical function. However, some patients do not have a good response to anti-TNF therapies, and in a recent study, researchers found that a significant proportion of patients with axSpA continue with anti-TNF therapy despite their suboptimal outcomes.
The researchers performed a retrospective analysis of 499 patients with axSpA who were treated at 2 centers in the United Kingdom between 2002 and 2016.
The proportion of patients who had a suboptimal response to anti-TNFs—classified as having a 2-point or higher reduction in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score without reaching BASDAI criteria for a 50% improvement and with BASDAI remaining at a score of 4 or above at 6 months—was 16.4%.
In this group, 78% were male, 95.1% had ankylosing spondylitis, and 82.1% were positive for Human leukocyte antigen B27. Mean (SD) time to diagnosis was 10 (8.6) years, age at diagnosis was 37 (11.7) years, and age at starting the index anti-TNF agent was 48 (11.1) years. Univariate and multivariate analyses of suboptimal responders showed that older age at starting anti-TNF therapy was the best predictor of suboptimal response.
The anti-TNF agents used in this group of suboptimal responders were adalimumab (50%), etanercept (32.9%), infliximab (6.1%), golimumab (3.7%), and certolizumab pegol (7.3%).
At 6 months and 1 year, respectively, survival rates among the suboptimal responders who stayed on their index anti-TNF agent were 90.2% and 85.1%. The rate of attrition was greater among suboptimal responders at 2 years and 5 years, but at 10 years, there was no difference between responders and suboptimal responders (67.6% and 68.4%; P = .064).
Notably, although more than 90% of patients with a suboptimal response remained on their index anti-TNF therapy at 6 months, the option for switching to different anti-TNF agents was available in both of the 2 centers where the patients were treated.
According to the authors, “a significant proportion of patients continued [anti-TNFs] despite demonstrating a sub-optimal response,” and further studies will be needed to understand suboptimal response among patients with axSpA, as well as to investigate the best treatment choices for this group of patients.
Reference
Yahya F, Gaffney K, Sengupta R. Exploring sub-optimal response to tumour necrosis factor inhibitors in axial spondyloarthritis. Rheumatol Adv Pract. 2019;3(1):rkzo12. PMCID: PMC6649897.
What Clinicians Need to Know About Using Biosimilars to Treat IBD
April 13th 2024A review article, intended to act as a guide for clinicians, summarizes the available infliximab and adalimumab biosimilars for treating inflammatory bowel disease (IBD) as well as others that are coming down the pipeline.
What AmerisourceBergen's Report Reveals About Payers, Biosimilar Pricing Trends
May 28th 2023On this episode of Not So Different, Tasmina Hydery and Brian Biehn from AmerisourceBergen discussed results from a recent survey, that were also presented at Asembia 2023, diving into the payer perspective on biosimilars and current pricing trends across the US biosimilar industry.
Study: More Biosimilar Competition Is Not Lowering Patient OOP Costs
March 29th 2024Despite more biosimilars entering the market and generating significant savings for payers and health care systems, these savings are not resulting in lower out-of-pocket (OOP) costs for patients, according to a recent study.
Pipelines and Preparation: How the US Can Prepare for More RA Biosimilars
April 16th 2023What can practices do to prepare for all the biosimilars to treat rheumatoid arthritis (RA) coming down the pipeline? And how can they ensure that the lower-than-anticipated adoption rates for infliximab biosimilars are not repeated? Robert Zutaut, RPh, from McKesson Provider Solutions, tackles all this and more on this episode of Not So Different.
The Role of Biosimilars: Advancing Access, Financial Health, and System Sustainability
March 11th 2024Kashyap Patel, MD, CEO of Carolina Blood and Cancer Care, a member of the Community Oncology Alliance, and member of The Center for Biosimilars® Advisory Board, glances back at the development of the biosimilar industry and the last 5 years of progress.