Comparative effectiveness of subcutaneous tocilizumab versus intravenous tocilizumab in a pan-European collaboration of registries

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Lauper , K , Mongin , D , Iannone , F , Kristianslund , E K , Kvien , T K , Nordström , D , Pavelka , K , Pombo-Suarez , M , Rotar , Z , Santos , M J , Codreanu , C , Lukina , G , Courvoisier , D S & Gabay , C 2018 , ' Comparative effectiveness of subcutaneous tocilizumab versus intravenous tocilizumab in a pan-European collaboration of registries ' , RMD open , vol. 4 , no. 2 , 000809 . https://doi.org/10.1136/rmdopen-2018-000809

Title: Comparative effectiveness of subcutaneous tocilizumab versus intravenous tocilizumab in a pan-European collaboration of registries
Author: Lauper, Kim; Mongin, Denis; Iannone, Florenzo; Kristianslund, Eirik Klami; Kvien, Tore K.; Nordström, Dan; Pavelka, Karel; Pombo-Suarez, Manuel; Rotar, Ziga; Santos, Maria Jose; Codreanu, Catalin; Lukina, Galina; Courvoisier, Delphine S.; Gabay, Cem
Contributor: University of Helsinki, Department of Medicine
Date: 2018-07
Language: eng
Number of pages: 9
Belongs to series: RMD open
ISSN: 2056-5933
URI: http://hdl.handle.net/10138/299273
Abstract: 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.
Subject: MODIFYING ANTIRHEUMATIC DRUGS
RHEUMATOID-ARTHRITIS PATIENTS
BODY-MASS INDEX
DISEASE
EFFICACY
COMBINATION
MONOTHERAPY
VALIDATION
MANAGEMENT
ADHERENCE
3121 Internal medicine
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