Efficacy of the first and subsequent treatment lines with adalimumab in patients with rheumatoid arthritis: data analysis from the Czech National Registry ATTRA
Abstract
Aims: The aim of our study was to analyse the efficacy of the first and subsequent treatment lines with TNFα blocker adalimumab within the rheumatoid arthritis patient registry ATTRA. Patients: In the evaluated period, there were total of 1245 RA patients analysed in the complete data file within the ATTRA-RA registry based on the evaluation criteria. 986 patients were treated in the first line and 259 subjects in the subsequent line.
Results: After 24 months, the DAS 28 score in the group treated in the first line with adalimumab reached a mean of 2,8 +- 1,1 (n = 387) vs. 3,0 +- 1,0 (n = 85) for subsequent line (p = 0,020). After two years of treatment, a good response according to the EULAR criteria was achieved in 68,7 % (n = 266) of patients treated in the first line vs. 56,5 % (n = 48) of patients treated in the subsequent line (p = 0,042).
After two years of treatment, the remission criteria were achieved in 45,2 % (n = 175) of patients in the first line and in 32,9 % (n = 28) of patients in subsequent line (p = 0,040). After one year of treatment with adalimumab, remission or low disease activity was attained by 41,7 % (n = 20) of patients switching for the reason of ineffectiveness, by 66,7 % (n = 12) of patients switching due to loss of efficacy and by 53,7 % (n = 22) of patients switching due to an adverse events.
Conclusion: Based on the results from the Czech National Registry ATTRA we can conclude that the efficacy of the first and subsequent treatment line with adalimumab is satisfactory and highly effective treatment strategy in clinical practice. The first line treatment was significantly better than the subsequent treatment line in the majority of the evaluated parameters.
The subsequent line was highly effective, particularly when the rationale for switching to adalimumab was a secondary failure or a presence of adverse event to the previous TNFα blocker.