دورية أكاديمية

Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry

التفاصيل البيبلوغرافية
العنوان: Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry
المؤلفون: Sebba, Anthony, Bingham, Clifton O., Bykerk, Vivian P., Fiore, Stefano, Ford, Kerri, Janak, Jud C., Pappas, Dimitrios A., Blachley, Taylor, Dave, Swapna S., Kremer, Joel M., Yu, Miao, Choy, Ernest
بيانات النشر: Springer
سنة النشر: 2023
المجموعة: Cardiff University: ORCA (Online Research @ Cardiff)
الوصف: ObjectiveRandomized controlled trials (RCTs) in biologic-naïve rheumatoid arthritis (RA) patients with high disease activity and inadequate response/intolerance to methotrexate have shown interleukin-6 (IL-6) receptor inhibitors (IL-6Ri) to be superior to tumor necrosis factor inhibitors (TNFi) as monotherapy. This observational study aimed to compare the effectiveness of TNFi vs IL-6Ri as mono- or combination therapy in biologic/targeted synthetic (b/ts) -experienced RA patients with moderate/high disease activity.MethodsEligible b/ts-experienced patients from the CorEvitas RA registry were categorized as TNFi and IL-6Ri initiators, with subgroups initiating as mono- or combination therapy. Mixed-effects regression models evaluated the impact of treatment on Clinical Disease Activity Index (CDAI), patient-reported outcomes, and disproportionate pain (DP). Unadjusted and covariate-adjusted effects were reported.ResultsPatients initiating IL-6Ri (n = 286) vs TNFi monotherapy (n = 737) were older, had a longer RA history and higher baseline CDAI, and were more likely to initiate as third-line therapy; IL-6Ri (n = 401) vs TNFi (n = 1315) combination therapy initiators had higher baseline CDAI and were more likely to initiate as third-line therapy. No significant differences were noted in the outcomes between TNFi and IL-6Ri initiators (as mono- or combination therapy).ConclusionThis observational study showed no significant differences in outcomes among b/ts-experienced TNFi vs IL-6Ri initiators, as either mono- or combination therapy. These findings were in contrast with the previous RCTs in biologic-naïve patients and could be explained by the differences in the patient characteristics included in this study. Further studies are needed to help understand the reasons for this discrepancy in the real-world b/ts-experienced population.
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: English
العلاقة: https://orca.cardiff.ac.uk/id/eprint/159748/1/TFN%20inhibitor.pdfTest; Sebba, Anthony, Bingham, Clifton O., Bykerk, Vivian P., Fiore, Stefano, Ford, Kerri, Janak, Jud C., Pappas, Dimitrios A., Blachley, Taylor, Dave, Swapna S., Kremer, Joel M., Yu, Miao and Choy, Ernest https://orca.cardiff.ac.uk/view/cardiffauthors/A227873K.htmlTest orcid:0000-0003-4459-8609 orcid:0000-0003-4459-8609 2023. Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry. Clinical Rheumatology 10.1007/s10067-023-06588-7 https://doi.org/10.1007/s10067-023-06588-7Test file https://orca.cardiff.ac.uk/id/eprint/159748/1/TFN%20inhibitor.pdfTest
DOI: 10.1007/s10067-023-06588-7
الإتاحة: https://doi.org/10.1007/s10067-023-06588-7Test
https://orca.cardiff.ac.uk/id/eprint/159748Test/
https://orca.cardiff.ac.uk/id/eprint/159748/1/TFN%20inhibitor.pdfTest
حقوق: cc_by_4_0
رقم الانضمام: edsbas.6E7C5563
قاعدة البيانات: BASE