A real-world comparison of clinical effectiveness in patients with rheumatoid arthritis treated with upadacitinib, tumor necrosis factor inhibitors, and other advanced therapies after switching from an initial tumor necrosis factor inhibitor
<p><strong>INTRODUCTION:</strong> This study compared the clinical effectiveness of switching from tumor necrosis factor inhibitor (TNFi) to upadacitinib (TNFi-UPA), another TNFi (TNFi-TNFi), or an advanced therapy with another mechanism of action (TNFi-other MOA) in patients with...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Springer
2024
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| _version_ | 1811141276161015808 |
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| author | Caporali, R Kadakia, A Howell, O Patel, J Milligan, J Strengholt, S Barlow, S Taylor, PC |
| author_facet | Caporali, R Kadakia, A Howell, O Patel, J Milligan, J Strengholt, S Barlow, S Taylor, PC |
| author_sort | Caporali, R |
| collection | OXFORD |
| description | <p><strong>INTRODUCTION:</strong> This study compared the clinical effectiveness of switching from tumor necrosis factor inhibitor (TNFi) to upadacitinib (TNFi-UPA), another TNFi (TNFi-TNFi), or an advanced therapy with another mechanism of action (TNFi-other MOA) in patients with rheumatoid arthritis (RA).</p>
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<p><strong>METHODS:</strong> Data were drawn from the Adelphi RA Disease Specific Programme™, a cross-sectional survey administered to rheumatologists and their consulting patients in Germany, France, Italy, Spain, the United Kingdom, Japan, Canada, and the United States from May 2021─January 2022. Patients who switched treatment from an initial TNFi were stratified by subsequent therapy of interest: TNFi-UPA, TNFi-TNFi, or TNFi-other MOA. Physician-reported clinical outcomes included disease activity (with formal DAS28 scoring available for 29% of patients) categorized as remission, LDA, MDA and HDA and pain were recorded at initiation of current treatment and ≥ 6 months from treatment switch. Fatigue and treatment adherence were measured ≥ 6 months from treatment switch. Inverse-probability–weighted regression adjustment compared outcomes by subsequent class of therapy: TNFi-UPA versus TNFi-TNFi, or TNFi-UPA versus TNFi-other MOA.</p>
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<p><Strong>RESULTS:</strong> Of 503 patients who switched from their first TNFi, 261 were in TNFi-UPA, 128 in TNFi-TNFi, and 114 in TNFi-other MOA groups. At the time of switch, most patients had moderate/high disease activity (TNFi-UPA: 73%; TNFi-TNFi: 52%; TNFi-other MOA: 60%). After adjusting for differences in characteristics at point of switch, patients in TNFi-UPA group (n=261) were significantly more likely to achieve physician-reported remission (67.7% vs. 40.3%; p=0.0015), no pain (55.7% vs. 25.4%; p=0.0007), and complete adherence (60.0% vs. 34.2%; p=0.0049) compared with patients in TNFi-TNFi group (n=121). Similar findings were observed for TNFi-UPA versus TNFi-other MOA groups (n=111).</p>
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<p><strong>CONCLUSION:</strong> Patients who switched from TNFi to UPA had significantly better clinical outcomes of remission, no pain, and complete adherence than those who cycled TNFi or switched to another MOA.</p> |
| first_indexed | 2024-09-25T04:35:18Z |
| format | Journal article |
| id | oxford-uuid:93a26c0b-5821-45ee-8f50-a59fdc3cd31f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:35:18Z |
| publishDate | 2024 |
| publisher | Springer |
| record_format | dspace |
| spelling | oxford-uuid:93a26c0b-5821-45ee-8f50-a59fdc3cd31f2024-09-16T10:58:51ZA real-world comparison of clinical effectiveness in patients with rheumatoid arthritis treated with upadacitinib, tumor necrosis factor inhibitors, and other advanced therapies after switching from an initial tumor necrosis factor inhibitorJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:93a26c0b-5821-45ee-8f50-a59fdc3cd31fEnglishSymplectic ElementsSpringer 2024Caporali, RKadakia, AHowell, OPatel, JMilligan, JStrengholt, SBarlow, STaylor, PC<p><strong>INTRODUCTION:</strong> This study compared the clinical effectiveness of switching from tumor necrosis factor inhibitor (TNFi) to upadacitinib (TNFi-UPA), another TNFi (TNFi-TNFi), or an advanced therapy with another mechanism of action (TNFi-other MOA) in patients with rheumatoid arthritis (RA).</p> <br> <p><strong>METHODS:</strong> Data were drawn from the Adelphi RA Disease Specific Programme™, a cross-sectional survey administered to rheumatologists and their consulting patients in Germany, France, Italy, Spain, the United Kingdom, Japan, Canada, and the United States from May 2021─January 2022. Patients who switched treatment from an initial TNFi were stratified by subsequent therapy of interest: TNFi-UPA, TNFi-TNFi, or TNFi-other MOA. Physician-reported clinical outcomes included disease activity (with formal DAS28 scoring available for 29% of patients) categorized as remission, LDA, MDA and HDA and pain were recorded at initiation of current treatment and ≥ 6 months from treatment switch. Fatigue and treatment adherence were measured ≥ 6 months from treatment switch. Inverse-probability–weighted regression adjustment compared outcomes by subsequent class of therapy: TNFi-UPA versus TNFi-TNFi, or TNFi-UPA versus TNFi-other MOA.</p> <br> <p><Strong>RESULTS:</strong> Of 503 patients who switched from their first TNFi, 261 were in TNFi-UPA, 128 in TNFi-TNFi, and 114 in TNFi-other MOA groups. At the time of switch, most patients had moderate/high disease activity (TNFi-UPA: 73%; TNFi-TNFi: 52%; TNFi-other MOA: 60%). After adjusting for differences in characteristics at point of switch, patients in TNFi-UPA group (n=261) were significantly more likely to achieve physician-reported remission (67.7% vs. 40.3%; p=0.0015), no pain (55.7% vs. 25.4%; p=0.0007), and complete adherence (60.0% vs. 34.2%; p=0.0049) compared with patients in TNFi-TNFi group (n=121). Similar findings were observed for TNFi-UPA versus TNFi-other MOA groups (n=111).</p> <br> <p><strong>CONCLUSION:</strong> Patients who switched from TNFi to UPA had significantly better clinical outcomes of remission, no pain, and complete adherence than those who cycled TNFi or switched to another MOA.</p> |
| spellingShingle | Caporali, R Kadakia, A Howell, O Patel, J Milligan, J Strengholt, S Barlow, S Taylor, PC A real-world comparison of clinical effectiveness in patients with rheumatoid arthritis treated with upadacitinib, tumor necrosis factor inhibitors, and other advanced therapies after switching from an initial tumor necrosis factor inhibitor |
| title | A real-world comparison of clinical effectiveness in patients with rheumatoid arthritis treated with upadacitinib, tumor necrosis factor inhibitors, and other advanced therapies after switching from an initial tumor necrosis factor inhibitor |
| title_full | A real-world comparison of clinical effectiveness in patients with rheumatoid arthritis treated with upadacitinib, tumor necrosis factor inhibitors, and other advanced therapies after switching from an initial tumor necrosis factor inhibitor |
| title_fullStr | A real-world comparison of clinical effectiveness in patients with rheumatoid arthritis treated with upadacitinib, tumor necrosis factor inhibitors, and other advanced therapies after switching from an initial tumor necrosis factor inhibitor |
| title_full_unstemmed | A real-world comparison of clinical effectiveness in patients with rheumatoid arthritis treated with upadacitinib, tumor necrosis factor inhibitors, and other advanced therapies after switching from an initial tumor necrosis factor inhibitor |
| title_short | A real-world comparison of clinical effectiveness in patients with rheumatoid arthritis treated with upadacitinib, tumor necrosis factor inhibitors, and other advanced therapies after switching from an initial tumor necrosis factor inhibitor |
| title_sort | real world comparison of clinical effectiveness in patients with rheumatoid arthritis treated with upadacitinib tumor necrosis factor inhibitors and other advanced therapies after switching from an initial tumor necrosis factor inhibitor |
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