Which advanced treatment should be used following the failure of a first-line anti-TNF in patients with rheumatoid arthritis? 15 years of evidence from the Quebec registry RHUMADATA
Authors' conclusion
Switching to an OMA, especially rituximab, in patients with failure to a first TNFi appears to be the best strategy as a second line of therapy.
Study context
- Population
- Patients with RA after failure of a first TNF inhibitors (TNFi), Quebec registry RHUMADATA, January 2007 to 25 November 2022
- Participants
- 611 patients
- Exposure
- Switch to a second TNFi vs a molecule with another mechanism of action (OMA) after failure of a first TNFi
- TNFin = 320reference
- OMAn = 291
- Outcome
- Treatment discontinuation (long-term retention)
Methodological detailsKaplan-Meier and Cox regression models, multiple imputation, propensity score-adjusted
- Kaplan-Meier and Cox regression models
- Multiple imputation
- Propensity score-adjusted
Main finding
Discontinuation
Adjusted hazard ratio
0.65
95% CI 0.44–0.94
By group
OMAvs TNFi
adjHR 0.65 (95% CI 0.44–0.94)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | adjHR (95% CI) | |
|---|---|---|
| Discontinuation, rituximab (stratified analysis)Rituximabvs TNFiAdjusted for patient characteristics | 0.39 (0.18–0.84) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Original publication
Which advanced treatment should be used following the failure of a first-line anti-TNF in patients with rheumatoid arthritis? 15 years of evidence from the Quebec registry RHUMADATA. Rheumatology (Oxford). Published 3 June 2024. doi:10.
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