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In RA patients, second-line golimumab therapy portrays
transient lower clinical responses in the first 6 months, without a reduction
in drug survival rate.
In biologic-failure and naïve psoriatic arthritis (PsA) and spondyloarthritis (SpA) patients, golimumab portrayed similar effectiveness; but it was less effective (particularly as monotherapy) in multi-failure rheumatoid arthritis (RA) patients, as concluded from a study issued in Joint Bone Spine journal. Male patients had the best outcomes.
The clinical efficacy of golimumab in biologic inadequate responder (IR) patients suffering from RA, SpA, and PsA has been assessed in this study.
Kaplan-Meier analysis was used to evaluate the drug
survival in biologic-naïve, 1-biologic IR, ≥2-biologics IR patients in a total
of 1424 patients. Multivariate Cox regression was used to evaluate hazard
ratios (HRs) of withdrawing golimumab at 2 years.
At 6 and 12 months, the patients achieving Clinical Disease
Activity Index (CDAI) based low disease activity (LDA) or with a Bath
Ankylosing Spondylitis Disease Activity Index (BASDAI) score of <4 were
examined.
In RA, SpA, and PsA patients, the 2-years survival with
the use of golimumab therapy compared between biologic-IR and
biologic-naïve patients has been portrayed in the following Table 1:
Table 1: 2-years survival of golimumab in RA, SpA, and PsA patients
Golimumab withdrawal was linked with monotherapy for RA; and female gender for SpA and PsA. In RA, patients on CDAI-LDA were lesser in 1-biologic IR or ≥2 biologics IR as compared to in the biologic-naïve group at six months; however, no such difference was detected at 12 months. The number of patients on CDAI-LDA or BASDAI<4 at 6 months was found to be nearly similar in the subgroups in PsA and SpA (as depicted in figure 1).
As
concluded, golimumab has shown to be as effective in 1-biologic IR as in
biologic-naive patients, with comparable drug survival and clinical outcomes in
patients with SpA and PsA. A significant better response to golimumab was
observed in RA biologic-naive patients than 2≥-biologic IR patients. The use of
MTX as co-therapy increased the retention rate of golimumab in RA but then
again not in patients with SpA or PsA.
Joint Bone Spine
Golimumab effectiveness in biologic inadequate responding patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis in real-life from the Italian registry GISEA
Florenzo Iannone et al.
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