As a Second Biologic for Spondyloarthritis, Treatment Shows High Retention Rates

Golimumab was effective and showed a high probability of treatment persistence up to 4 years as a second anti-tumor necrosis factor (anti-TNF) drug in patients with spondyloarthritis who needed to discontinue their first anti-TNF drug for reasons other than primary nonresponse, according to a study published online in the journal Medicine. 

“Because persistence with the same anti-TNF drug in second-line treatment decreases the overall disease-associated costs compared with non-persistence, this aspect … merits consideration by physicians and payers when choosing a biological drug,” researchers wrote. 

The retrospective study included 131 patients with axial spondyloarthritis and 79 patients with psoriatic arthritis who started golimumab as a second anti-TNF drug.  

In patients with axial spondyloarthritis, the average Bath Ankylosing Spondylitis Disease Activity Index score decreased from 5.5 at baseline to 3.9 at month 3 of golimumab treatment. By year 1, the score decreased to 3.5, where it remained stable afterward. In patients with psoriatic arthritis, the Disease Activity Score averaged 4.0 at baseline, decreased to 2.5 at month 3, and decreased to 2.2 at year 1. C-reactive protein levels and erythrocyte sedimentation rates in both patient groups improved similarly, according to the study. 

The probability of persistence of golimumab treatment was 80% at year 1, 70% at year 2, and 65% at years 3 and year 4. Persistence was similar in patients who had discontinued their first anti-TNF drug due to loss of efficacy or for other reasons, researchers noted. 

Among a total 72 patients who discontinued golimumab during follow-up, 50 did so because of a lack of efficacy. 

“Changing from one biological drug to another has been reported to be associated with an increase in treatment costs. Nonetheless, treatment switching is required (and recommended) where there is treatment failure or intolerance,” researchers wrote.  

“Choosing a subsequent anti-TNF drug with a high survival or persistence rate is, therefore, an important factor in the economics of patient management for patients with rheumatic disease.”

—Jolynn Tumolo

Reference:

Alegre-Sancho JJ, Juanola X, Rodríguez-Heredia JM, et al. Effectiveness and persistence of golimumab as a second biological drug in patients with spondyloarthritis: A retrospective study. Medicine (Baltimore). 2021;100(13):e25223. doi:10.1097/MD.0000000000025223