Switching to rituximab more efficacious than switching anti-TNF agents

Switching to rituximab may be more efficacious than switching anti–tumor necrosis factor agents in patients with moderate to severe rheumatoid arthritis and prior exposure to anti-TNF agents, data from the observational Corrona registry show.

In an adjusted analyses of two drug exposure cohorts categorized using propensity scores, patients treated with rituximab were 35%-50% more likely to achieve low disease activity or remission (primary outcome) than were those treated with a subsequent anti-TNF agent, reported Dr. Leslie Harrold of the University of Massachusetts, Worcester, and associates. However, this finding was not statistically significant in patients who fell outside the area of common support (trimmed population), the authors noted (Arthritis Res Ther. 2015;17:256).

Patients treated with rituximab also were more likely to achieve the study’s secondary outcomes of modified American College of Rheumatology (mACR) 20 and mACR 50 responses (trimmed population only) and demonstrate clinically meaningful improvement in modified Health Assessment Questionnaire scores than were those treated with a subsequent anti-TNF.

Overall, 265 rituximab users and 737 patients on anti-TNF agents were included in the analysis. Approximately 16.2% of rituximab users and 29.4% of users of anti-TNF agents switched to another biologic during the study period.

An analysis of safety events over the 12-month study showed the rate of new adverse events per 100 patient years was similar between groups.

The results of the study reinforce important observations from European studies that switching to rituximab is superior to receiving another anti-TNF agent and expand upon the findings with a rigorous evaluation of the comparative safety of these two drug classes, the study authors said. “This is important because patients and the rheumatologists treating them need a comprehensive evaluation of the benefit-risk profiles of different biologic agents to optimize decision making,” they wrote.

“Taken together, these results suggest that in a clinical practice, rituximab may be more efficacious than a subsequent anti-TNF agent in patients with moderately active to severely active RA and prior exposure to anti-TNF agents,” they concluded.

Corrona LLC sponsored the study. The Corrona registry has been supported by several pharmaceutical companies. Two authors are employees of Genentech.

Switching to rituximab may be more efficacious than switching anti–tumor necrosis factor agents in patients with moderate to severe rheumatoid arthritis and prior exposure to anti-TNF agents, data from the observational Corrona registry show.

In an adjusted analyses of two drug exposure cohorts categorized using propensity scores, patients treated with rituximab were 35%-50% more likely to achieve low disease activity or remission (primary outcome) than were those treated with a subsequent anti-TNF agent, reported Dr. Leslie Harrold of the University of Massachusetts, Worcester, and associates. However, this finding was not statistically significant in patients who fell outside the area of common support (trimmed population), the authors noted (Arthritis Res Ther. 2015;17:256).

Patients treated with rituximab also were more likely to achieve the study’s secondary outcomes of modified American College of Rheumatology (mACR) 20 and mACR 50 responses (trimmed population only) and demonstrate clinically meaningful improvement in modified Health Assessment Questionnaire scores than were those treated with a subsequent anti-TNF.

Overall, 265 rituximab users and 737 patients on anti-TNF agents were included in the analysis. Approximately 16.2% of rituximab users and 29.4% of users of anti-TNF agents switched to another biologic during the study period.

An analysis of safety events over the 12-month study showed the rate of new adverse events per 100 patient years was similar between groups.

The results of the study reinforce important observations from European studies that switching to rituximab is superior to receiving another anti-TNF agent and expand upon the findings with a rigorous evaluation of the comparative safety of these two drug classes, the study authors said. “This is important because patients and the rheumatologists treating them need a comprehensive evaluation of the benefit-risk profiles of different biologic agents to optimize decision making,” they wrote.

“Taken together, these results suggest that in a clinical practice, rituximab may be more efficacious than a subsequent anti-TNF agent in patients with moderately active to severely active RA and prior exposure to anti-TNF agents,” they concluded.

Corrona LLC sponsored the study. The Corrona registry has been supported by several pharmaceutical companies. Two authors are employees of Genentech.

Switching to rituximab may be more efficacious than switching anti–tumor necrosis factor agents in patients with moderate to severe rheumatoid arthritis and prior exposure to anti-TNF agents, data from the observational Corrona registry show.

In an adjusted analyses of two drug exposure cohorts categorized using propensity scores, patients treated with rituximab were 35%-50% more likely to achieve low disease activity or remission (primary outcome) than were those treated with a subsequent anti-TNF agent, reported Dr. Leslie Harrold of the University of Massachusetts, Worcester, and associates. However, this finding was not statistically significant in patients who fell outside the area of common support (trimmed population), the authors noted (Arthritis Res Ther. 2015;17:256).

Patients treated with rituximab also were more likely to achieve the study’s secondary outcomes of modified American College of Rheumatology (mACR) 20 and mACR 50 responses (trimmed population only) and demonstrate clinically meaningful improvement in modified Health Assessment Questionnaire scores than were those treated with a subsequent anti-TNF.

Overall, 265 rituximab users and 737 patients on anti-TNF agents were included in the analysis. Approximately 16.2% of rituximab users and 29.4% of users of anti-TNF agents switched to another biologic during the study period.

An analysis of safety events over the 12-month study showed the rate of new adverse events per 100 patient years was similar between groups.

The results of the study reinforce important observations from European studies that switching to rituximab is superior to receiving another anti-TNF agent and expand upon the findings with a rigorous evaluation of the comparative safety of these two drug classes, the study authors said. “This is important because patients and the rheumatologists treating them need a comprehensive evaluation of the benefit-risk profiles of different biologic agents to optimize decision making,” they wrote.

“Taken together, these results suggest that in a clinical practice, rituximab may be more efficacious than a subsequent anti-TNF agent in patients with moderately active to severely active RA and prior exposure to anti-TNF agents,” they concluded.

Corrona LLC sponsored the study. The Corrona registry has been supported by several pharmaceutical companies. Two authors are employees of Genentech.