Comparative effectiveness of biologic antirheumatic therapies in rheumatoid arthritis after failure to respond to a first TNF inhibitor
Abstract
Evaluation of: Gomez-Reino JJ, Maneiro JR, Ruiz J et al. Comparative effectiveness of switching to alternative tumour necrosis factor (TNF) antagonists versus switching to rituximab in patients with rheumatoid arthritis who failed previous TNF antagonists: the MIRAR Study. Ann. Rheum. Dis. doi:10.1136/annrheumdis-2012-201324 (2012) (Epub ahead of print). Rheumatoid arthritis is a chronic immune-mediated disease affecting approximately 1% of the population. The prognosis of this chronic condition has considerably improved over the past decade with the earlier use of antirheumatic drugs and the introduction of new biologic therapies. Current treatment guidelines recommend using these agents after a failed response to conventional disease-modifying antirheumatic drugs, but the relative positioning of the various available biologic agents is not yet well established. All biologic agents have been proven to be superior to placebo in large trials, but only very few randomized controlled trials have compared directly competing therapeutic options. This article evaluates the effectiveness of rituximab compared with an alternative TNF antagonist (anti-TNF) in rheumatoid arthritis patients who experienced a previous failed response to anti-TNF. The results of this large observational cohort study suggest that rituximab offers a greater benefit on rheumatoid arthritis disease activity than alternative monoclonal anti-TNFs.
References
- 1 Felts W, Yelin E. The economic impact of the rheumatic diseases in the United States. J. Rheumatol.16,867–884 (1989)Medline, CAS, Google Scholar
- 2 Fighting disease, fostering development, The WHO Report (1996).Google Scholar
- 3 Schiff M, Keiserman M, Codding C et al. Efficacy and safety of abatacept or infliximab vs placebo in ATTEST: a Phase III, multi-centre, randomised, double-blind, placebo-controlled study in patients with rheumatoid arthritis and an inadequate response to methotrexate. Ann. Rheum. Dis.67,1096–1103 (2008).Crossref, Medline, CAS, Google Scholar
- 4 O’Dell JR. It is the best of times; it is the worst of times: is there a way forward? A plethora of treatment options for rheumatoid arthritis, but critical trial design issues. Arthritis Rheum.56,3884–3886 (2007).Crossref, Medline, Google Scholar
- 5 Rubbert-Roth A, Finckh A. Treatment options in patients with rheumatoid arthritis failing initial TNF inhibitor therapy: a critical review. Arthritis Res. Ther.11(Suppl.1),S1 (2009).Crossref, Medline, Google Scholar
- 6 Gomez-Reino JJ, Maneiro JR, Ruiz J et al. Comparative effectiveness of switching to alternative tumour necrosis factor (TNF) antagonists versus switching to rituximab in patients with rheumatoid arthritis who failed previous TNF antagonists: the MIRAR Study. Ann. Rheum. Dis. doi:10.1136/annrheumdis-2012-201324 (2012) (Epub ahead of print).Google Scholar
- 7 Finckh A, Ciurea A, Brulhart L et al. B cell depletion may be more effective than switching to an alternative anti-tumor necrosis factor agent in rheumatoid arthritis patients with inadequate response to anti-tumor necrosis factor agents. Arthritis Rheum.56,1417–1423 (2007).Crossref, Medline, Google Scholar
- 8 Finckh A, Ciurea A, Brulhart L et al. Which subgroup of patients with rheumatoid arthritis benefits from switching to rituximab versus alternative anti-tumour necrosis factor (TNF) agents after previous failure of an anti-TNF agent? Ann. Rheum. Dis.69,387–393 (2010).Crossref, Medline, CAS, Google Scholar
- 9 Kekow J, Mueller-Ladner U, Schulze-Koops H. Rituximab is more effective than second anti-TNF therapy in rheumatoid arthritis patients and previous TNFα blocker failure. Biologics6,191–199 (2012).Medline, CAS, Google Scholar
- 10 Blom M, Kievit W, Donders AR et al. Effectiveness of a third tumor necrosis factor-α-blocking agent compared with rituximab after failure of 2 TNF-blocking agents in rheumatoid arthritis. J. Rheumatol.38,2355–2361 (2011).Crossref, Medline, CAS, Google Scholar
- 11 Moetaza M, Hyrich K, Lunt M et al. Rituximab or a second anti-tumor necrosis factor therapy for rheumatoid arthritis patients who have failed their first anti-tumor necrosis factor therapy? Comparative analysis from the british society for rheumatology biologics register. Arthritis Care Res.64,1108–1115 (2012).Crossref, Google Scholar
- 12 Emery P, Gottenberg J, Sarzi-Puttini P et al. Relative effectiveness of rituximab versus an alternative TNF inhibitor in patients with rheumatoid arthritis and an inadequate response to a single previous TNF inhibitor: results from SWITCH-RA, a global, comparative-effectiveness, observational study. Arthritis Rheum63(Suppl. 10),126 (2011).Crossref, Google Scholar
- 13 Rituximab versus anti-TNF in RA patients who previously failed one TNF inhibitor in an observational cohort. Scand. J. Rheum. (2012) (In Press).Google Scholar
- 14 Finckh A. Comparative effectiveness of rheumatoid arthritis therapies. Curr. Rheum. Rep.12,348–354 (2011).Crossref, Google Scholar
- 15 Gabay C, Emery P, van Vollenhoven R et al. Tocilizumab (TCZ) monotherapy is superior to adalimumab (ADA) monotherapy in reducing disease activity in patients with rheumatoid arthritis (RA): 24-week data from the phase 4 ADACTA trial. Ann. Rheum. Dis.71(Suppl. 3),152, Abstract LB0003 (2012).Crossref, Google Scholar
- 16 Schiff M, Fleischmann R, Weinblatt M et al. Abatacept SC versus adalimumab on background methotrexate in RA: one year results from the AMPLE study. EULAR Ann. Science Meeting. Ann. Rheum. Dis.60,OP0022 (2012).Google Scholar
- 101 Moreland LW, Genovese MC. National Institute of Allergy and Infectious Diseases (NIAID): switching anti-TNF-α agents in RA (NCT00796705). Clinicaltrials.gov, NCT00796705 (2008). http://clinicaltrials.gov/ct2/show/NCT00796705?term=tumour+necrosis+inadequate+response&rank=5Google Scholar
- 102 Gottenberg J. Rotation or change of biotherapy after first anti-TNF treatment failure for rheumatoid arthritis (ROC). Clinicaltrials.gov. NCT01000441 (2009). http://clinicaltrials.gov/ct2/show/NCT01000441?term=rheumatoid+arthritis&type=Intr&cond=rheumatoid+arthritis&intr=rituximab&rank=33Google Scholar
