Tapering Biologic RA Treatment Successful, Cost-Effective in Certain Patients

Patients with rheumatoid arthritis who achieve low disease activity or remission may successfully taper their biologic disease-modifying antirheumatic drugs (bDMARDs), saving costs as a result, according to research findings presented this week in Chicago at the 2018 American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting.

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A group of researchers from the Université Catholique de Louvain (UCLouvain) in Brussels, Belgium, conducted a retrospective study to evaluate the proportion of patients for whom bDMARDs can be tapered in daily clinical practice. They also analyzed the characteristics of “tapering” patients, determined which biologics more easily adapt to dose tapering and looked at cost savings.

The study included 332 eligible RA patients from an UCLouvain cohort who were treated with a bDMARD for at least one year; 140 of these pateints were tapered. Dose reduction was proposed by a senior physician when a patient achieved low disease activity or remission. The researchers also collected data on patient characteristics and baseline features before the introduction of the current bDMARD, and when flares occurred. They also calculated the proportion of patients who received a decreased dose and the annual cost for each bDMARD.

According to informtion in a press release about the findings, "no differences between the groups were observed for gender, anti-citrullinated protein antibody (ACPA), erosions, the number of previous bDMARDs, the time to first conventional synthetic DMARD and bDMARD, baseline DAS28-CRP and glucocorticoid use. As expected, current DAS28-CRP (Disease Activity 28 and C-Reactive Protein) scores were lower in the tapered dose group. Only 15 patients had a flare during the follow-up."

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Anti-tumor necrosis factor (TNF) agents were the most commonly prescribed bDMARDs in this cohort. Adalimumab, etanercept and rituximab were the most frequently tapered bDMARD in the study, and these were also associated with the most important reductions in annual cost. The study’s findings show that in daily clinical practice, a large proportion of RA patients with low disease activity or remission may successfully taper bDMARDs and reduce annual cost.

“Tapering of biologics is essential in daily care,” Patrick Durez, MD, Head of Clinic, Division of Rheumatology, at Université Catholique de Louvain (UCLouvain) explained in a press release about the findings. “The unmet needs for this research are numerous, including the physician’s decision not to follow guidelines addressed by the industry.”

This article was originally published on Pharmacy Times.

References

• Dierckx S, Lauwerys Br, Sokolova T. Tapering of Biological Antirheumatic Drugs in Rheumatoid Arthritis Patients Is Achievable and Cost Effective in Daily Clinical Practice: DATA from the Brussels UCL RA Cohort. Presented at: ACR/ARHP 2018 Annual Meeting; October 19-24, 2018; Chicago, IL. Abstract 625.
• Biologic Tapering Successful and Cost-effective in RA Patients with Low Disease Activity. [news release]. Chicago, IL: American College of Rheumatology. Published October 20, 2018. Accessed October 22, 2018.