Department of Medicine, Division of Preventive And Behavioral Medicine
Musculoskeletal Diseases | Pharmaceutical Preparations | Rheumatology | Therapeutics
INTRODUCTION: Current recommendations for the management of rheumatoid arthritis (RA) focus on a treat-to-target approach with the objective of maximizing long-term health-related quality-of-life in patients with RA. Published studies from randomized clinical trials have reported limited data regarding the long-term efficacy and safety of adalimumab in patients with RA. This study aims to evaluate the long-term (10+ years) persistency and effectiveness of adalimumab in patients with RA in a real-world setting.
METHODS: Included in this study were biologic-naive adults with RA initiating adalimumab during follow-up enrolled in the Corrona RA registry. More than 10 years of data on persistency of adalimumab and rheumatologist-supplied reasons for discontinuation were examined. Among patients who persisted on adalimumab over the years, clinical [e.g., clinical disease activity index scores (CDAI), physician global assessment, tender joint count, and swollen joint count] and patient-reported outcomes (PRO), such as physical function, pain, fatigue, and morning stiffness, were examined.
RESULTS: Of 1791 biologic-naive patients treated with adalimumab who had > /=1 follow-up registry visit, 64.1% were still on therapy at 1 year and 10.2% were still on therapy by the end of year 12. Among patients who persisted on adalimumab for at least 1 year (77.1% female, mean age 53.9 years), 67.0% were in low disease activity (LDA)/remission (CDAI < /=10) and had clinically meaningful improvements from baseline in all clinical assessments and PROs. Initial improvements in LDA/remission and in clinical and PRO assessments observed at year 1 were sustained in those patients who remained on adalimumab over 10 years of follow-up. Among patients who discontinued adalimumab, 61.6% were not in LDA/remission and 41.9% switched to another biologic within 12 months after discontinuing adalimumab.
CONCLUSIONS: Real-world data demonstrate a sustained effectiveness of adalimumab in the treatment of RA for patients who remained on therapy for 10 years.
FUNDING: Corrona, LLC and AbbVie.
Adalimumab, Biologic, Corrona, Real-world, Rheumatoid arthritis, Treat-to-target
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© The Author(s) 2017. This article is an open access publication. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
DOI of Published Version
Rheumatol Ther. 2017 Dec;4(2):375-389. doi: 10.1007/s40744-017-0077-z. Epub 2017 Aug 24. Link to article on publisher's site
Rheumatology and therapy
Pappas, Dimitrios A.; Kremer, Joel M.; Griffith, Jenny; Reed, George W.; Salim, Bob; Karki, Chitra; and Garg, Vishvas, "Long-Term Effectiveness of Adalimumab in Patients with Rheumatoid Arthritis: An Observational Analysis from the Corrona Rheumatoid Arthritis Registry" (2017). Open Access Articles. 3242.
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This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License