The persistence of golimumab compared to other tumour necrosis factor-α inhibitors in daily clinical practice for the treatment of rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: observations from the Slovenian nation-wide longitudinal registry of patients treated with biologic disease-modifying antirheumatic drugs-BioRx.si

Abstract

To assess the persistence of golimumab and other tumour necrosis factor-α inhibitors (TNFis) in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in Slovenia. We analysed prospectively the collected data of all patients treated with golimumab and other TNFis from 1 January 2010 to 31 July 2018 from the mandatory national BioRx.si registry. We assessed the treatment persistence stratified by treatment type, indication and prior exposure to bDMARDs using the Kaplan-Meier method and Cox proportional regression hazards' models adjusted for the well-appreciated confounders. We also assessed its effectiveness at 1 year after the initiation of therapy. During the 7-year observation period, 24 Slovenian rheumatologists from eight centres contributed data on 368, and 1654 patients treated for 849, and 3321 person-years with golimumab and other TNFis, respectively. The overall proportions of RA, AS and PsA patients being persistent on golimumab vs. other TNFis at 2 years after starting the therapy did not differ significantly and were 53%, 67% and 59% vs. 47%, 65% and 59%, respectively. The crude and adjusted hazard ratios for golimumab discontinuation did not differ significantly between bDMARD-naïve and bDMARD-experienced patients for any of the indications. In contrast, bDMARD-experienced AS and PsA patients treated with other TNFis were significantly more likely to discontinue treatment. The persistence of golimumab in patients with RA, AS and PsA in Slovenia was comparable with its persistence in more affluent Western European countries. We observed a better persistence of golimumab compared to other TNFis in bDMARD-experienced AS and PsA patients.

Keywords: Ankylosing spondylitis; Biologic agents; Psoriatic arthritis; Rheumatoid arthritis.