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Comparative efficacy of tocilizumab, abatacept and rituximab after non‐TNF inhibitor failure: results from a multicentre study
Author(s) -
Pascart Tristan,
Philippe Peggy,
Drumez Elodie,
Deprez Xavier,
Cortet Bernard,
Duhamel Alain,
Houvenagel Eric,
Flipo RenéMarc
Publication year - 2016
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12845
Subject(s) - abatacept , tocilizumab , medicine , rituximab , erythrocyte sedimentation rate , rheumatoid arthritis , clinical endpoint , gastroenterology , surgery , randomized controlled trial , lymphoma
Aims The aim of this study was to compare the efficacy of tocilizumab, rituximab and abatacept after a non‐tumor necrosis factor inhibitor (non‐TNFi) failure for the treatment of rheumatoid arthritis (RA). Materials and methods This retrospective multi‐centre study included patients treated for RA with abatacept, rituximab or tocilizumab after having received in the previous line the first non‐TNFi. Data were collected from patient charts. The primary endpoint was the delta Disease Activity Index of 28 joints – erythrocyte sedimentation rate (DAS28‐ESR) and DAS28‐CRP (C‐reactive protein) at 12 months. The relative change in primary outcome measures from baseline were calculated. Results One hundred patients started a second non‐TNFi between 2006 and 2013, including 15 patients treated with rituximab, 36 with tocilizumab and 49 with abatacept. The change of DAS28‐ESR was significantly different between the three groups ( P = 0.001). In post hoc pairwise comparisons, patients treated with tocilizumab had a higher decrease of the DAS28‐ESR than patients treated by abatacept (median [interquartile range: IQR]: 36% [0; 54%] vs . 0% [0; 20%], P = 0.002). A similar non‐significant difference was found between tocilizumab and rituximab (median [IQR] decrease: 36% [0; 54%] vs . 0% [−11; 34%], P = 0.07). Similar results were found with the 12 months change in DAS28‐CRP. Conclusions This study suggests a better efficacy of tocilizumab compared with abatacept and rituximab in situations of non‐TNFi failure.