Drug survival rates of biological disease-modifying antirheumatic drugs and Janus kinase-inhibitor therapy in 801 rheumatoid arthritis patients: a 14 year-retrospective study from a rheumatology clinic in Japan

Abstract

Objectives: To assess long-term outcomes for seven biological disease-modifying antirheumatic drugs (bDMARDs) and one Janus kinase (JAK)-inhibitor in rheumatoid arthritis.

Methods: We retrospectively analyzed data from 801 rheumatoid arthritis patients visiting our rheumatology clinic between 2003 and 2017. We determined drug survival rates, drug discontinuation, and switching rates in these patients.

Results: Among the drugs administered to naïve subjects, the drug-survival rate was highest for tocilizumab, at 77.8% after 6 years, whereas the rates for golimumab, etanercept, abatacept, infliximab, and adalimumab, were 61.5%, 48.9%, 41.6%, 34.5%, and 34.4%, respectively. Switching drugs led to decreased survival rates. The discontinuation rates for all drugs due to adverse events and poor efficacy increased rapidly in the first 2 years and the first 6 months, respectively.

Conclusions: This report is a long-term analysis of a large cohort of rheumatoid arthritis patients from a single rheumatology clinic in Japan. We conclude that to maximize the survival rate of antirheumatic drugs, it is important to maintain their effectiveness over long periods of time by appropriate drug choices and optimizing dosage before switching drugs.

Keywords:

• Biological disease-modifying antirheumatic drug (bDMARD)
• discontinuation
• disease activity score-28 for RA with erythrocyte sedimentation rate (DAS28-ESR)
• drug survival
• rheumatoid arthritis

Acknowledgements

The authors would like to express their appreciation to Ms. Mie Maruo, medical secretary, who organized and managed the study dates over a long period of time. Editorial support, in the form of medical writing, assembling tables, and creating high-resolution images based on detailed directions, collating comments, copy-editing, fact-checking, and referencing, was provided by Editage, Cactus Communications.

Conflicts of interest

M.K. received lecture fees from Chugai Pharmaceutical, Mitsubishi-Tanabe Pharma, Janssen Pharmaceutical, Pfizer, Eisai, Abbvie, Bristol-Myers, and Astellas.

H.Y. received lecture fees from Chugai Pharmaceutical, Janssen Pharmaceutical, Pfizer, Eisai, Bristol-Myers, and Astellas.