Switching to IV golimumab from IV infliximab improves disease activity in RA
USA: Switching to IV-golimumab from IV-infliximab is beneficial in patients with rheumatoid arthritis (RA) as it may improve drug tolerance and disease activity, reveals a recent study involving real-world patients.
"Results of the study using RISE data indicate the effectiveness of IV-golimumab in improving RA disease activity in a patient population switching directly from IV-infliximab," John Tesser, Arizona Arthritis & Rheumatology Associates, Phoenix, AZ, USA, and colleagues wrote in their study published in the journal Clinical Rheumatology. This was measured by a standard disease activity index aligned with ACR and EULAR treat-to-target guidelines called CDAI.
"These results are clinically meaningful and may be helpful in providing patients with improved and sustained outcomes given the limited real-world data reporting the efficacy of IV-infliximab-to-IV-golimumab switching."
Golimumab and infliximab are intravenously (IV) administered tumor necrosis factor inhibitors approved for the treatment of moderate-to-severe rheumatoid arthritis with concomitant methotrexate. However, due to the differences in their biological construct, patients with rheumatoid arthritis (RA) with a failure response to IV-infliximab may benefit from switching to IV-golimumab.
Using real-world data from ACR's Rheumatology Informatics System for Effectiveness (RISE), Dr. Tesser and colleagues aimed to evaluate the efficacy of switching from IV-infliximab to IV-golimumab to control RA disease activity. RISE is a large electronic health records registry based in the USA.
The longitudinal, retrospective, single-arm study included adults with ≥ 1 RA diagnosis code between 2014 and 2018 and ≥ 1 IV-infliximab prescription within 6 months of a new IV-golimumab order (index date). Clinical Disease Activity Index (CDAI) was used to calculate longitudinal assessments of disease activity in patients continuing IV-golimumab for 6–9- and 9–12-months post-switch. During the follow-up periods, paired t-tests evaluated significance of mean improvements.
The study revealed the following findings:
- Most RA patients with disease activity assessments during the 6-month follow-up (N = 100; mean age: 65.3 years; 81% female; 74% white) demonstrated moderate-to-high disease activity (CDAI: 73% [38/52]) at enrollment.
- On average, patients showed significant improvement in disease activity within 6–9 months of switching; mean CDAI scores improved from 21.3 to 14.1 and were durable through 9–12 months of treatment.
- Real-world patients with moderate-to-high disease activity who switched from IV-infliximab to IV-golimumab demonstrated significant and sustained improvements post-switch as measured by the CDAI.
"Given the limited real-world data documenting efficacy of IV-infliximab-to-IV-golimumab switching, these results are clinically meaningful and may assist clinicians in providing patients with improved and sustained outcomes," the authors concluded.
Reference:
Tesser, J., Lin, I., Shiff, N.J. et al. Improvement in disease activity among patients with rheumatoid arthritis who switched from intravenous infliximab to intravenous golimumab in the ACR RISE registry. Clin Rheumatol (2022). https://doi.org/10.1007/s10067-022-06116-z
KEYWORDS: rheumatoid arthritis, golimumab, infliximab, IV, intravenous, Clinical Rheumatology, disease activity, tumor necrosis factor, John Tesser, drug tolerance
