Drug retention of secondary biologics or JAK inhibitors after tocilizumab or abatacept failure as first biologics in patients with rheumatoid arthritis -the ANSWER cohort study-

Ebina, Kosuke; Hirano, Toru; Maeda, Yuichi; Yamamoto, Wataru; Hashimoto, Motomu; Murata, Koichi; Takeuchi, Tohru; Nagai, Koji; Son, Yonsu; Amuro, Hideki; Onishi, Akira; Jinno, Sadao; Hara, Ryota; Katayama, Masaki; Yamamoto, Keiichi; Kumanogoh, Atsushi; Hirao, Makoto

doi:https://doi.org/10.1007/s10067-020-05015-5

Drug retention of secondary biologics or JAK inhibitors after tocilizumab or abatacept failure as first biologics in patients with rheumatoid arthritis -the ANSWER cohort study-

Ebina, Kosuke; Hirano, Toru; Maeda, Yuichi et al.

Clinical Rheumatology, 2020, 39(9), 2563-2572

Number of Access:2,109（2025-07-06 18:34 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/93249

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Title	Drug retention of secondary biologics or JAK inhibitors after tocilizumab or abatacept failure as first biologics in patients with rheumatoid arthritis -the ANSWER cohort study-
Creator	NRID 1000070612076 1000070612076 researchmap permalink k-ebina k-ebina Scopus Author ID 8415453300 8415453300 ORCID 0000-0002-2426-1024 0000-0002-2426-1024 CreatorName Ebina, Kosuke
	CreatorName Hirano, Toru
	NRID 1000010815658 1000010815658 CreatorName Maeda, Yuichi
	CreatorName Yamamoto, Wataru
	NRID 1000060512845 1000060512845 CreatorName Hashimoto, Motomu
	NRID 1000060806793 1000060806793 CreatorName Murata, Koichi
	NRID 1000010330078 1000010330078 CreatorName Takeuchi, Tohru
	NRID 1000030572458 1000030572458 CreatorName Nagai, Koji
	CreatorName Son, Yonsu
	CreatorName Amuro, Hideki
	CreatorName Onishi, Akira
	CreatorName Jinno, Sadao
	NRID 1000010597107 1000010597107 CreatorName Hara, Ryota
	CreatorName Katayama, Masaki
	CreatorName Yamamoto, Keiichi
	NRID 1000010294125 1000010294125 researchmap permalink read0051725 read0051725 Scopus Author ID 6602726311 6602726311 ORCID 0000-0003-4749-7117 0000-0003-4749-7117 CreatorName Kumanogoh, Atsushi
	NRID 1000010527708 1000010527708 CreatorName Hirao, Makoto
Subject	Abatacept
	Biologics
	Drug retention
	Janus kinase inhibitors
	Rheumatoid arthritis
	Tocilizumab
Description	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s10067-020-05015-5
Description	Ebina K., Hirano T., Maeda Y., et al. Drug retention of secondary biologics or JAK inhibitors after tocilizumab or abatacept failure as first biologics in patients with rheumatoid arthritis -the ANSWER cohort study-. Clinical Rheumatology 39, 2563 (2020)
Abstract	Objectives: The aim of this multicenter, retrospective study was to clarify the retention of secondary biological disease-modifying antirheumatic drugs (bDMARDs) or Janus kinase inhibitors (JAKi) in patients with rheumatoid arthritis (RA) who were primarily treated by tocilizumab (TCZ) or abatacept (ABT) as first bDMARDs. Method: Patients who were treated by either TCZ (n = 145) or ABT (n = 76) and then switched to either tumor necrosis factor inhibitors (TNFi), TCZ, ABT, or JAKi (including only cases switched from TCZ) from 2001 to 2019 (female 81.0%, age 59.5 years, disease duration 8.8 years; rheumatoid factor positivity 75.4%; Disease Activity Score in 28 joints using C-reactive protein 3.7; concomitant prednisolone (PSL) dose 6.0 mg/day (51.8%) and methotrexate (MTX) dose 8.0 mg/week (56.1%); 81.9% discontinued first bDMARDs due to lack of effectiveness) were included. Drug retention and discontinuation reasons were estimated at 24 months using the Kaplan-Meier method and adjusted for potential confounders by Cox proportional hazards modeling. Results: Drug retentions for each of the reasons for discontinuation were as follows: lack of effectiveness in TCZ-switched group (TNFi (59.5%), ABT (82.2%), and JAKi (84.3%); TNFi vs. ABT; P = 0.009) and ABT-switched group (TNFi (79.6%) and TCZ (92.6%); P = 0.053). Overall retention excluding non-toxic reasons and remission for discontinuation were TNFi (49.9%), ABT (72.7%), and JAKi (72.6%) (TNFi vs. ABT; P = 0.017) in the TCZ-switched group and TNFi (69.6%) and TCZ (72.4%) (P = 0.44) in the ABT-switched group. Conclusions: Switching to ABT in TCZ-treated patients led to higher retention as compared with TNFi. Switching to TCZ in ABT-treated patients tended to lead to higher retention due to effectiveness, although total retention was similar as compared with TNFi.Key Point• This is the first retrospective, multi-center study aimed to clarify the retention rates of secondary bDMARDs or JAKi in patients with RA who were primarily being treated by TCZ or ABT as the first bDMARDs.
Publisher	Springer Science and Business Media Deutschland GmbHinfo@springer-sbm.com
Source Title	Clinical Rheumatology
Volume (Issue)	39(9)
Page	2563-2572
Date of Issued	2020-09-01
Language	English
Handle URL	https://hdl.handle.net/11094/93249
PISSN	07703198
eISSN	14349949
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1007/s10067-020-05015-5
Access Rights	open access
CopyRight	© 2020, International League of Associations for Rheumatology (ILAR).
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Clinical Rheumatology. 2020, 39(9), p. 2563-2572
DC.title	Drug retention of secondary biologics or JAK inhibitors after tocilizumab or abatacept failure as first biologics in patients with rheumatoid arthritis -the ANSWER cohort study-
DC.creator	Ebina, Kosuke
	Hirano, Toru
	Maeda, Yuichi
	Yamamoto, Wataru
	Hashimoto, Motomu
	Murata, Koichi
	Takeuchi, Tohru
	Nagai, Koji
	Son, Yonsu
	Amuro, Hideki
	Onishi, Akira
	Jinno, Sadao
	Hara, Ryota
	Katayama, Masaki
	Yamamoto, Keiichi
	Kumanogoh, Atsushi
	Hirao, Makoto
DC.publisher	Springer Science and Business Media Deutschland GmbHinfo@springer-sbm.com
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2020-09-01
DC.identifier	https://doi.org/10.1007/s10067-020-05015-5
DC.subject	Abatacept
	Biologics
	Drug retention
	Janus kinase inhibitors
	Rheumatoid arthritis
	Tocilizumab
DC.description	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s10067-020-05015-5
DC.description	Ebina K., Hirano T., Maeda Y., et al. Drug retention of secondary biologics or JAK inhibitors after tocilizumab or abatacept failure as first biologics in patients with rheumatoid arthritis -the ANSWER cohort study-. Clinical Rheumatology 39, 2563 (2020)
DCTERMS.abstract	Objectives: The aim of this multicenter, retrospective study was to clarify the retention of secondary biological disease-modifying antirheumatic drugs (bDMARDs) or Janus kinase inhibitors (JAKi) in patients with rheumatoid arthritis (RA) who were primarily treated by tocilizumab (TCZ) or abatacept (ABT) as first bDMARDs. Method: Patients who were treated by either TCZ (n = 145) or ABT (n = 76) and then switched to either tumor necrosis factor inhibitors (TNFi), TCZ, ABT, or JAKi (including only cases switched from TCZ) from 2001 to 2019 (female 81.0%, age 59.5 years, disease duration 8.8 years; rheumatoid factor positivity 75.4%; Disease Activity Score in 28 joints using C-reactive protein 3.7; concomitant prednisolone (PSL) dose 6.0 mg/day (51.8%) and methotrexate (MTX) dose 8.0 mg/week (56.1%); 81.9% discontinued first bDMARDs due to lack of effectiveness) were included. Drug retention and discontinuation reasons were estimated at 24 months using the Kaplan-Meier method and adjusted for potential confounders by Cox proportional hazards modeling. Results: Drug retentions for each of the reasons for discontinuation were as follows: lack of effectiveness in TCZ-switched group (TNFi (59.5%), ABT (82.2%), and JAKi (84.3%); TNFi vs. ABT; P = 0.009) and ABT-switched group (TNFi (79.6%) and TCZ (92.6%); P = 0.053). Overall retention excluding non-toxic reasons and remission for discontinuation were TNFi (49.9%), ABT (72.7%), and JAKi (72.6%) (TNFi vs. ABT; P = 0.017) in the TCZ-switched group and TNFi (69.6%) and TCZ (72.4%) (P = 0.44) in the ABT-switched group. Conclusions: Switching to ABT in TCZ-treated patients led to higher retention as compared with TNFi. Switching to TCZ in ABT-treated patients tended to lead to higher retention due to effectiveness, although total retention was similar as compared with TNFi.Key Point• This is the first retrospective, multi-center study aimed to clarify the retention rates of secondary bDMARDs or JAKi in patients with RA who were primarily being treated by TCZ or ABT as the first bDMARDs.
DC.rights	© 2020, International League of Associations for Rheumatology (ILAR).
DC.format	93249
citation_title	Drug retention of secondary biologics or JAK inhibitors after tocilizumab or abatacept failure as first biologics in patients with rheumatoid arthritis -the ANSWER cohort study-
citation_author	Ebina, Kosuke
	Hirano, Toru
	Maeda, Yuichi
	Yamamoto, Wataru
	Hashimoto, Motomu
	Murata, Koichi
	Takeuchi, Tohru
	Nagai, Koji
	Son, Yonsu
	Amuro, Hideki
	Onishi, Akira
	Jinno, Sadao
	Hara, Ryota
	Katayama, Masaki
	Yamamoto, Keiichi
	Kumanogoh, Atsushi
	Hirao, Makoto
citation_publisher	Springer Science and Business Media Deutschland GmbHinfo@springer-sbm.com
citation_language	English
citation_date	2020-09-01
citation_journal_title	Clinical Rheumatology
citation_volume	39
citation_issue	9
citation_firstpage	2563
citation_lastpage	2572
citation_doi	https://doi.org/10.1007/s10067-020-05015-5
citation_public_url	https://hdl.handle.net/11094/93249

Drug retention of secondary biologics or JAK inhibitors after tocilizumab or abatacept failure as first biologics in patients with rheumatoid arthritis -the ANSWER cohort study-

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