PMID- 27018857
OWN - NLM
STAT- MEDLINE
DCOM- 20170523
LR  - 20170523
IS  - 1756-185X (Electronic)
IS  - 1756-1841 (Linking)
VI  - 19
IP  - 11
DP  - 2016 Nov
TI  - Comparative efficacy of tocilizumab, abatacept and rituximab after non-TNF 
      inhibitor failure: results from a multicentre study.
PG  - 1093-1102
LID - 10.1111/1756-185X.12845 [doi]
AB  - AIMS: The aim of this study was to compare the efficacy of tocilizumab, rituximab 
      and abatacept after a non-tumor necrosis factor inhibitor (non-TNFi) failure for 
      the treatment of rheumatoid arthritis (RA). MATERIALS AND METHODS: This 
      retrospective multi-centre study included patients treated for RA with abatacept, 
      rituximab or tocilizumab after having received in the previous line the first 
      non-TNFi. Data were collected from patient charts. The primary endpoint was the 
      delta Disease Activity Index of 28 joints - erythrocyte sedimentation rate 
      (DAS28-ESR) and DAS28-CRP (C-reactive protein) at 12 months. The relative change 
      in primary outcome measures from baseline were calculated. RESULTS: One hundred 
      patients started a second non-TNFi between 2006 and 2013, including 15 patients 
      treated with rituximab, 36 with tocilizumab and 49 with abatacept. The change of 
      DAS28-ESR was significantly different between the three groups (P = 0.001). In 
      post hoc pairwise comparisons, patients treated with tocilizumab had a higher 
      decrease of the DAS28-ESR than patients treated by abatacept (median 
      [interquartile range: IQR]: 36% [0; 54%] vs. 0% [0; 20%], P = 0.002). A similar 
      non-significant difference was found between tocilizumab and rituximab (median 
      [IQR] decrease: 36% [0; 54%] vs. 0% [-11; 34%], P = 0.07). Similar results were 
      found with the 12 months change in DAS28-CRP. CONCLUSIONS: This study suggests a 
      better efficacy of tocilizumab compared with abatacept and rituximab in 
      situations of non-TNFi failure.
CI  - (c) 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons 
      Australia, Ltd.
FAU - Pascart, Tristan
AU  - Pascart T
AD  - Department of Rheumatology, Saint-Philibert Hospital, Lille University, Lomme, 
      France.
AD  - Department of Rheumatology, CHU Lille, Lille, France.
AD  - EA 4490, University-Hospital of Lille, CHU Lille, Lille, France.
FAU - Philippe, Peggy
AU  - Philippe P
AD  - Department of Rheumatology, CHU Lille, Lille, France.
FAU - Drumez, Elodie
AU  - Drumez E
AD  - Department of Biostatistics, Univ. Lille, CHU Lille, Lille, France.
FAU - Deprez, Xavier
AU  - Deprez X
AD  - Department of Rheumatology, Valenciennes Hospital, Valenciennes, France.
FAU - Cortet, Bernard
AU  - Cortet B
AD  - Department of Rheumatology, CHU Lille, Lille, France.
AD  - EA 4490, University-Hospital of Lille, CHU Lille, Lille, France.
FAU - Duhamel, Alain
AU  - Duhamel A
AD  - Department of Biostatistics, Univ. Lille, CHU Lille, Lille, France.
FAU - Houvenagel, Eric
AU  - Houvenagel E
AD  - Department of Rheumatology, Saint-Philibert Hospital, Lille University, Lomme, 
      France.
FAU - Flipo, Rene-Marc
AU  - Flipo RM
AD  - Department of Rheumatology, CHU Lille, Lille, France.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20160327
PL  - England
TA  - Int J Rheum Dis
JT  - International journal of rheumatic diseases
JID - 101474930
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Biological Products)
RN  - 0 (Biomarkers)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 7D0YB67S97 (Abatacept)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - I031V2H011 (tocilizumab)
SB  - IM
MH  - Abatacept/adverse effects/*therapeutic use
MH  - Aged
MH  - Antibodies, Monoclonal, Humanized/adverse effects/*therapeutic use
MH  - Antirheumatic Agents/adverse effects/*therapeutic use
MH  - Arthritis, Rheumatoid/blood/diagnosis/*drug therapy/immunology
MH  - Biological Products/adverse effects/*therapeutic use
MH  - Biomarkers/blood
MH  - Blood Sedimentation
MH  - C-Reactive Protein/metabolism
MH  - Drug Substitution
MH  - Female
MH  - France
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Rituximab/adverse effects/*therapeutic use
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Treatment Failure
OTO - NOTNLM
OT  - abatacept
OT  - biologics failure
OT  - rheumatoid arthritis
OT  - rituximab
OT  - tocilizumab
EDAT- 2016/03/29 06:00
MHDA- 2017/05/24 06:00
CRDT- 2016/03/29 06:00
PHST- 2016/03/29 06:00 [pubmed]
PHST- 2017/05/24 06:00 [medline]
PHST- 2016/03/29 06:00 [entrez]
AID - 10.1111/1756-185X.12845 [doi]
PST - ppublish
SO  - Int J Rheum Dis. 2016 Nov;19(11):1093-1102. doi: 10.1111/1756-185X.12845. Epub 
      2016 Mar 27.