AB0476 Influence of the Reason for Discontinuation of Previous TNF Antagonists on the Retention of Tocilizumab
Authors: N. Asai, Y. Yabe, T. Kojima, N. Takahashi, K. Funahashi, S. Asai, T. Takemoto, K. Terabe, Y. Yoshioka, N. Ishiguro
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Tocilizumab (TCZ) is effective for rheumatoid arthritis (RA) patients with inadequate responses to tumor necrosis factor (TNF) antagonists. Previous report showed that among RA patients who were switched to a second TNF antagonist, the reasons for stopping a second drug were related to the reasons for stopping the first drug<sup>1</sup>. However, it has not yet been established whether the type of failure that motivated the switch from TNF antagonists influences the retention of TCZ. <h3>Objectives</h3> The present study was undertaken to investigate the relationship between the retention of TCZ and the reason for discontinuation of previous TNF antagonists in RA patients. <h3>Methods</h3> This study included 191 RA patients who switched from TNF antagonists to TCZ therapy in Tsurumai Biologics Communication Registry (TBCR). The retention rates of TCZ at 2 years were calculated by the Kaplan-Meier method and compared using the log-rank test between two groups divided by the reasons for discontinuation of previous TNF antagonists (162 patients with inefficacy; LOE group, and 29 patients with adverse events; AE group). <h3>Results</h3> There were no differences between the two groups in terms of age, disease duration, TNF antagonist before switch, concomitant MTX use, or DAS28-ESR at the switch to TCZ therapy. The discontinuation rate of TCZ at 2 years in LOE group was significantly lower compared with AE group (p=0.023, log-rank test). No significant differences existed between the two groups for treatment discontinuation due to inefficacy (p=0.476). On the other hand, the discontinuation rate due to adverse events was significantly lower for LOE group compared with AE group (p=0.001). <h3>Conclusions</h3> RA patients who switched from TNF antagonists due to inefficacy to TCZ have high rates of continuation. <h3>References</h3> Hyrich KL, et al. Outcomes after switching from one anti-tumor necrosis factor alpha agent to a second anti-tumor necrosis factor alpha agent in patients with rheumatoid arthritis: results from a large UK national cohort study. Arthritis Rheum. 2007 Jan;56(1):13-20. <h3>Disclosure of Interest</h3> N. Asai: None declared, Y. Yabe: None declared, T. Kojima Grant/research support from: Takeda Pharma Corporation, Janssen Pharmaceutical, and Astellas Pharma Corporation., Speakers bureau: Mitsubishi Tanabe Pharma Corporation, Takeda Pharma Corporation, Eisai Pharma Corporation, Abbvie, Bristol-Myers Squibb, Pfizer, Chugai Pharma Corporation, Janssen Pharmaceutical, and Astellas Pharma Corporation., N. Takahashi: None declared, K. Funahashi: None declared, S. Asai Speakers bureau: Eisai Pharma Corporation., T. Takemoto: None declared, K. Terabe: None declared, Y. Yoshioka: None declared, N. Ishiguro Grant/research support from: Daiichi Sankyo, Takeda Pharmaceutical, Hisamitsu Pharmaceutical, Otsuka Pharmaceutical, Taisho Toyama Pharmaceutical, Kaken Pharmaceutical, Eisai, Janssen Pharmaceutical, Bristol-Myers Squibb, Abbott Japan, Chugai Pharmaceutical, Mitsubishi Tanabe Pharmaceutical, Astellas Pharma, and Pfizer Japan., Speakers bureau: Daiichi Sankyo, Takeda Pharmaceutical, Hisamitsu Pharmaceutical, Otsuka Pharmaceutical, Taisho Toyama Pharmaceutical, Kaken Pharmaceutical, Eisai, Janssen Pharmaceutical, Bristol-Myers Squibb, Abbott Japan, Chugai Pharmaceutical, Mitsubishi Tanabe Pharmaceutical, Astellas Pharma, and Pfizer Japan.