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.