Comparative effectiveness of subcutaneous tocilizumab versus intravenous tocilizumab in a pan-European collaboration of registries
Status PubMed-not-MEDLINE Jazyk angličtina Země Anglie, Velká Británie Médium electronic-ecollection
Typ dokumentu časopisecké články
PubMed
30488002
PubMed Central
PMC6241977
DOI
10.1136/rmdopen-2018-000809
PII: rmdopen-2018-000809
Knihovny.cz E-zdroje
- Klíčová slova
- DMARDs, biological therapies, epidemiology, intravenous, rheumatoid arthritis, subcutaneous, tocilizumab,
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: To compare the real-word effectiveness of subcutaneous tocilizumab (TCZ-SC) and intravenous tocilizumab (TCZ-IV) in rheumatoid arthritis (RA). METHODS: Patients with RA with TCZ from eight European registries were included. Drug retention was compared using unadjusted Kaplan-Meier and Cox models adjusted for baseline patient, disease and treatment characteristics, using a strata term for year of treatment initiation and country of registry. The proportions of patients achieving Clinical Disease Activity Index (CDAI) remission and low disease activity (LDA) at 1 year were compared using samples matched on the same covariates and corrected for attrition using LUNDEX. RESULTS: 3448 patients were retrieved, 2414 with TCZ-IV and 1034 with TCZ-SC. Crude median retention was 3.52 years (95% CI 3.22 to 3.85) for TCZ-IV and 2.12 years for TCZ-SC (95% CI 1.88 to 2.38). In a country-stratified and year of treatment initiation-stratified, covariate-adjusted analysis, hazards of discontinuation were similar between TCZ-SC and TCZ-IV treated patients (HR 0.93, 95% CI 0.80 to 1.09). The average adjusted CDAI change at 1 year was similar in both groups (-6.08). After matching, with 560 patients in each group, CDAI remission corrected for attrition at 1 year was also similar between TCZ-SC and TCZ-IV (10.4% in TCZ-IV vs 12.8% in TCZ-SC (difference: 2.4%, bootstrap 95% CI -2.1% to 7.6%)), but CDAI LDA was lower in TCZ-IV patients: 41.0% in TCZ-IV versus 49.1% in TCZ-SC (difference: 8.0 %; bootstrap 95% CI 2.4% to 12.4%). CONCLUSION: With similar retention and effectiveness, TCZ-SC is an adequate alternative to TCZ-IV for RA. When possible, considering the costs of the TCZ-IV route, TCZ-SC should be the preferred mode of administration.
ARBITER Institute of Rheumatology Moscow Russian Federation
Center of Rheumatic Diseases University of Medicine and Pharmacy Bucharest Romania
Department of Medicine ROB FIN Helsinki University Hospital and Helsinki University Helsinki Finland
Department of Rheumatology BioRx si University Medical Centre Ljubljana Ljubljana Slovenia
Department of Rheumatology Diakonhjemmet Hospital Oslo Norway
Division of Rheumatology Geneva University Hospitals Geneva Switzerland
Institute of Rheumatology Prague and Clinic of Rheumatology Charles University Prague Czech Republic
Rheumatology Department on behalf of Reuma pt Hospital Garcia de Orta Almada Portugal
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