Comparative effectiveness of antitumour necrosis factor agents, biologics with an alternative mode of action and tofacitinib in an observational cohort of patients with rheumatoid arthritis in Switzerland

Finckh, A; Tellenbach, C; Herzog, L; Scherer, A; Moeller, B; Ciurea, A; von Muehlenen, I; Gabay, C; Kyburz, D; Brulhart, L; Müller, R; Hasler, P; Zufferey, P

doi:10.1136/rmdopen-2020-001174

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-25911

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Comparative effectiveness of antitumour necrosis factor agents, biologics with an alternative mode of action and tofacitinib in an observational cohort of patients with rheumatoid arthritis in Switzerland
Authors:	Finckh, A Tellenbach, C Herzog, L Scherer, A Moeller, B Ciurea, A von Muehlenen, I Gabay, C Kyburz, D Brulhart, L Müller, R Hasler, P Zufferey, P
et. al:	No
DOI:	10.1136/rmdopen-2020-001174 10.21256/zhaw-25911
Published in:	RMD Open
Volume(Issue):	6
Page(s):	e001174
Issue Date:	2020
Publisher / Ed. Institution:	BMJ Publishing Group
ISSN:	2056-5933
Language:	English
Subjects:	Abatacept; Biological therapy; Comparative effectiveness research; Rheumatoid arthritis; Tocilizumab; Tumour necrosis alpha inhibitor
Subject (DDC):	615: Pharmacology and therapeutics 616.7: Diseases of musculoskeletal system and orthopaedics
Abstract:	Background: Multiple biologic and targeted synthetic disease-modifying rheumatic drugs (b/tsDMARDs) are approved for the management of rheumatoid arthritis (RA), including TNF inhibitors (TNFi), bDMARDs with other modes of action (bDMARD-OMA) and Janus kinase inhibitors (JAKi). Combination of b/tsDMARDs with conventional synthetic DMARDs (csDMARDs) is recommended, yet monotherapy is common in practice. Objective: To compare drug maintenance and clinical effectiveness of three alternative treatment options for RA management. Methods: This observational cohort study was nested within the Swiss RA Registry. TNFi, bDMARD-OMA (abatacept or anti-IL6 agents) or the JAKi tofacitinib (Tofa) initiated in adult RA patients were included. The primary outcome was overall drug retention. We further analysed secondary effectiveness outcomes and whether concomitant csDMARDs modified effectiveness, adjusting for potential confounding factors. Results: 4023 treatment courses of 2600 patients were included, 1862 on TNFi, 1355 on bDMARD-OMA and 806 on Tofa. TNFi was more frequently used as a first b/tsDMARDs, at a younger age and with shorter disease duration. Overall drug maintenance was significantly lower with TNFi compared with Tofa [HR 1.29 (95% CI 1.14 to 1.47)], but similar between bDMARD-OMA and Tofa [HR 1.09 (95% CI 0.96 to 1.24)]. TNFi maintenance was decreased when prescribed without concomitant csDMARDs [HR: 1.27 (95% CI 1.08 to 1.49)], while no difference was observed for bDMARD-OMA or Tofa maintenance with respect to concomitant csDMARDs. Conclusion: Tofa drug maintenance was comparable with bDMARDs-OMA and somewhat higher than TNFi. Concomitant csDMARDs appear to be required for optimal effectiveness of TNFi, but not for bDMARD-OMA or Tofa.
URI:	https://digitalcollection.zhaw.ch/handle/11475/25911
Fulltext version:	Published version
License (according to publishing contract):	CC BY-NC 4.0: Attribution - Non commercial 4.0 International
Departement:	School of Engineering
Organisational Unit:	Institute of Data Analysis and Process Design (IDP)
Appears in collections:	Publikationen School of Engineering

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Finckh, A., Tellenbach, C., Herzog, L., Scherer, A., Moeller, B., Ciurea, A., von Muehlenen, I., Gabay, C., Kyburz, D., Brulhart, L., Müller, R., Hasler, P., & Zufferey, P. (2020). Comparative effectiveness of antitumour necrosis factor agents, biologics with an alternative mode of action and tofacitinib in an observational cohort of patients with rheumatoid arthritis in Switzerland. RMD Open, 6, e001174. https://doi.org/10.1136/rmdopen-2020-001174

Finckh, A. et al. (2020) ‘Comparative effectiveness of antitumour necrosis factor agents, biologics with an alternative mode of action and tofacitinib in an observational cohort of patients with rheumatoid arthritis in Switzerland’, RMD Open, 6, p. e001174. Available at: https://doi.org/10.1136/rmdopen-2020-001174.

A. Finckh et al., “Comparative effectiveness of antitumour necrosis factor agents, biologics with an alternative mode of action and tofacitinib in an observational cohort of patients with rheumatoid arthritis in Switzerland,” RMD Open, vol. 6, p. e001174, 2020, doi: 10.1136/rmdopen-2020-001174.

FINCKH, A, C TELLENBACH, L HERZOG, A SCHERER, B MOELLER, A CIUREA, I VON MUEHLENEN, C GABAY, D KYBURZ, L BRULHART, R MÜLLER, P HASLER und P ZUFFEREY, 2020. Comparative effectiveness of antitumour necrosis factor agents, biologics with an alternative mode of action and tofacitinib in an observational cohort of patients with rheumatoid arthritis in Switzerland. RMD Open. 2020. Bd. 6, S. e001174. DOI 10.1136/rmdopen-2020-001174

Finckh, A, C Tellenbach, L Herzog, A Scherer, B Moeller, A Ciurea, I von Muehlenen, et al. 2020. “Comparative Effectiveness of Antitumour Necrosis Factor Agents, Biologics with an Alternative Mode of Action and Tofacitinib in an Observational Cohort of Patients with Rheumatoid Arthritis in Switzerland.” RMD Open 6: e001174. https://doi.org/10.1136/rmdopen-2020-001174.

Finckh, A., et al. “Comparative Effectiveness of Antitumour Necrosis Factor Agents, Biologics with an Alternative Mode of Action and Tofacitinib in an Observational Cohort of Patients with Rheumatoid Arthritis in Switzerland.” RMD Open, vol. 6, 2020, p. e001174, https://doi.org/10.1136/rmdopen-2020-001174.