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Observational Study
. 2023 May 22;25(1):86.
doi: 10.1186/s13075-023-03045-3.

Factors associated with discontinuation of biologics in patients with inflammatory arthritis in remission: data from the BIOBADASER registry

Marta Valero  1 , Carlos Sánchez-Piedra  2 , Mercedes Freire  3 , María Colazo  4 , Noemí Busquets  5 , Erardo Meriño-Ibarra  6 , Carlos Rodríguez-Lozano  7 , Sara Manrique  8 , Cristina Campos  9 , Fernando Sánchez-Alonso  10 , Isabel Castrejón  11
Affiliations
Observational Study

Factors associated with discontinuation of biologics in patients with inflammatory arthritis in remission: data from the BIOBADASER registry

Marta Valero et al. Arthritis Res Ther. .

Erratum in

Abstract

Background: The objectives of this study were to assess the discontinuation of biologic therapy in patients who achieve remission and identify predictors of discontinuation of biologics in patients with inflammatory arthritis in remission.

Methods: An observational retrospective study from the BIOBADASER registry comprising adult patients diagnosed with rheumatoid arthritis (RA), ankylosing spondylitis (AS), or psoriatic arthritis (PsA) and receiving 1 or 2 biological disease-modifying drugs (bDMARDs) between October 1999 and April 2021. Patients were followed yearly after initiation of therapy or until discontinuation of treatment. Reasons for discontinuation were collected. Patients who discontinued bDMARDs because of remission as defined by the attending clinician were studied. Predictors of discontinuation were explored using multivariable regression models.

Results: The study population comprised 3,366 patients taking 1 or 2 bDMARDs. Biologics were discontinued owing to remission by 80 patients (2.4%): 30 with RA (1.7%), 18 with AS (2.4%), and 32 with PsA (3.9%). The factors associated with a higher probability of discontinuation on remission were shorter disease duration (OR: 0.95; 95% CI: 0.91-0.99), no concomitant use of classic DMARDs (OR: 0.56; 95% CI: 0.34-0.92), and shorter usage of the previous bDMARD (before the decision to discontinue biological therapy) (OR: 1.01; 95% CI: 1.01-1.02); in contrast, smoking status (OR: 2.48; 95% CI: 1.21-5.08) was associated with a lower probability. In patients with RA, positive ACPA was associated with a lower probability of discontinuation (OR: 0.11; 95% CI: 0.02-0.53).

Conclusions: Discontinuation of bDMARDs in patients who achieve remission is uncommon in routine clinical care. Smoking and positive ACPA in RA patients were associated with a lower probability of treatment discontinuation because of clinical remission.

Keywords: Biologic DMARD; Discontinuation; Real-world evidence; Remission.

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Conflict of interest statement

Marta Valero has received honoraria for presentations from Novartis, Lilly, MSD, Abbvie, and UCB and consulting fees from Novartis. Other co-authors declare that they have no competing interests regarding this manuscript

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