Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: Results from the international TOCERRA and PANABA observational collaborative studies
Authors' conclusion
After initiation of a bDMARD, glucocorticoid use decreased similarly in all treatment groups. However, glucocorticoid withdrawal was much slower than advocated by current international guidelines.
Study context
- Population
- Patients with rheumatoid arthritis (RA) initiating TNFi, abatacept or tocilizumab, with available information on oral GC use, from 13 observational registries13 registries
- Participants
- 12,334 / 2,100 / 3,229
- Comparison
- TNFi vs tocilizumab vs abatacept
- TNF-inhibitorsn = 12,334reference
- Tocilizumabn = 2,100
- Abataceptn = 3,229
- Outcome
- Oral GC withdrawal
Methodological details13 observational registries, multinational, random-effects meta-analysis, Cox regression adjusted for patient, treatment and disease characteristics
- 13 observational registries
- Multinational
- Random-effects meta-analysis
- Cox regression adjusted for patient, treatment and disease characteristics
Pooled result
As reported in the abstract
Oral GC discontinuation in patients with GC at baseline
Each group vs TNF-inhibitorsEstimate (CI)
Abatacept
crude HR 0.65(0.48–0.87)
Tocilizumab
crude HR 1.04(0.76–1.43)
Abatacept
aHR 1.1(0.83–1.47)
Tocilizumab
aHR 1.30(0.96–1.78)
Further pooled results
| Outcome | TNF-inhibitors | Tocilizumab | Abatacept |
|---|---|---|---|
| Oral GC use, stopping vs starting (OR) · 1 yearMcNemar test | |||
| OR stopping vs starting (95% CI 1.58; 3.04) | 2.19 | — not stated in the abstract | — not stated in the abstract |
| OR stopping vs starting (1.39; 4.35) | — not stated in the abstract | 2.46 | — not stated in the abstract |
| OR stopping vs starting (1.25; 2.21) | — not stated in the abstract | — not stated in the abstract | 1.73 |
— not stated in the abstract
Oral GC use, stopping vs starting (OR) · 1 year
- Oral GC use decreased in all treatment groups
Original publication
Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: Results from the international TOCERRA and PANABA observational collaborative studies. Joint Bone Spine. Published 30 November 2023. doi:10.
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