At 6 months and 1 year, respectively, survival rates among the suboptimal responders who stayed on their index anti–tumor necrosis factor (anti-TNF) agent were 90.2% and 85.1%, respectively.
Using anti—tumor necrosis factor (anti-TNF) agents in the treatment of axial spondyloarthritis (axSpA) is associated with good efficacy and improvements in pain, disease activity, and physical function. However, some patients do not have a good response to anti-TNF therapies, and in a recent study, researchers found that a significant proportion of patients with axSpA continue with anti-TNF therapy despite their suboptimal outcomes.
The researchers performed a retrospective analysis of 499 patients with axSpA who were treated at 2 centers in the United Kingdom between 2002 and 2016.
The proportion of patients who had a suboptimal response to anti-TNFs—classified as having a 2-point or higher reduction in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score without reaching BASDAI criteria for a 50% improvement and with BASDAI remaining at a score of 4 or above at 6 months—was 16.4%.
In this group, 78% were male, 95.1% had ankylosing spondylitis, and 82.1% were positive for Human leukocyte antigen B27. Mean (SD) time to diagnosis was 10 (8.6) years, age at diagnosis was 37 (11.7) years, and age at starting the index anti-TNF agent was 48 (11.1) years. Univariate and multivariate analyses of suboptimal responders showed that older age at starting anti-TNF therapy was the best predictor of suboptimal response.
The anti-TNF agents used in this group of suboptimal responders were adalimumab (50%), etanercept (32.9%), infliximab (6.1%), golimumab (3.7%), and certolizumab pegol (7.3%).
At 6 months and 1 year, respectively, survival rates among the suboptimal responders who stayed on their index anti-TNF agent were 90.2% and 85.1%. The rate of attrition was greater among suboptimal responders at 2 years and 5 years, but at 10 years, there was no difference between responders and suboptimal responders (67.6% and 68.4%; P = .064).
Notably, although more than 90% of patients with a suboptimal response remained on their index anti-TNF therapy at 6 months, the option for switching to different anti-TNF agents was available in both of the 2 centers where the patients were treated.
According to the authors, “a significant proportion of patients continued [anti-TNFs] despite demonstrating a sub-optimal response,” and further studies will be needed to understand suboptimal response among patients with axSpA, as well as to investigate the best treatment choices for this group of patients.
Reference
Yahya F, Gaffney K, Sengupta R. Exploring sub-optimal response to tumour necrosis factor inhibitors in axial spondyloarthritis. Rheumatol Adv Pract. 2019;3(1):rkzo12. PMCID: PMC6649897.
Competitive Pricing in Biosimilars: How Adalimumab Could Shape the Industry
Published: October 29th 2024 | Updated: October 29th 2024Sophia Humphreys, PharmD, MHA, BCBBS, of Sutter Health notes that although initial adoption of adalimumab biosimilars remained low in 2023, competitive pricing pressures have already benefited patients and the health care sector.
Biosimilars in America: Overcoming Barriers and Maximizing Impact
July 21st 2024Join us as we explore the complexities of the US biosimilars market, discussing legislative influences, payer and provider adoption factors, and strategies to overcome industry challenges with expert insights from Kyle Noonan, PharmD, MS, value & access strategy manager at Cencora.
Sandoz Report: A Unified Approach to Overcoming Drug Shortages
October 10th 2024A report from Sandoz emphasizes the need for collaboration among stakeholders to eliminate drug shortages impacting over 90% of hospital systems in the US, recommending policy changes and actions to address the ongoing issue, which has caused treatment delays and increased costs.
What AmerisourceBergen's Report Reveals About Payers, Biosimilar Pricing Trends
May 28th 2023On this episode of Not So Different, Tasmina Hydery and Brian Biehn from AmerisourceBergen discussed results from a recent survey, that were also presented at Asembia 2023, diving into the payer perspective on biosimilars and current pricing trends across the US biosimilar industry.
AAM Report: Despite Massive Savings, Patient OOP Costs on Biosimilars, Generics Remain High, Part 2
September 24th 2024Part 2 of our series diving into the Association for Accessible Medicines' (AAM) latest report discusses that while generics and biosimilars saved $445 billion in 2023, their potential is hindered by high patient costs, drug shortages, and ineffective policies, underscoring the need for reforms to fully realize their benefits.
AAM Report: Generics and Biosimilars Savings Reach $445 Billion in 2023, Part 1
September 18th 2024Savings from generic and biosimilar drugs totaled $445 billion in 2023, showing promise for the growth of both markets and highlighting the success of expansion policies for these products, according to a new report from the Association for Accessible Medicines (AAM).