Treatment Sequences After Discontinuing a Tumor Necrosis Factor Inhibitor in Patients With Rheumatoid Arthritis: A Comparison of Cycling Versus Swapping Strategies.
Adult
Aged
Arthritis, Rheumatoid
/ diagnosis
Cost Savings
Cost-Benefit Analysis
Databases, Factual
Drug Administration Schedule
Drug Costs
Drug Substitution
/ adverse effects
Female
Humans
Male
Middle Aged
Retrospective Studies
Time Factors
Treatment Outcome
Tumor Necrosis Factor Inhibitors
/ administration & dosage
United States
Journal
Arthritis care & research
ISSN: 2151-4658
Titre abrégé: Arthritis Care Res (Hoboken)
Pays: United States
ID NLM: 101518086
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
17
12
2019
accepted:
09
06
2020
pubmed:
20
6
2020
medline:
16
11
2021
entrez:
20
6
2020
Statut:
ppublish
Résumé
To evaluate the sequences of tumor necrosis factor inhibitors (TNFi) and non-TNFi used by rheumatoid arthritis (RA) patients whose initial TNFi therapy has failed, and to evaluate effectiveness and costs. Using the Truven Health MarketScan Research database, we analyzed claims of commercially insured adult patients with RA who switched to their second biologic or targeted disease-modifying antirheumatic drug between January 2008 and December 2015. Our primary outcome was the frequency of treatment sequences. Our secondary outcomes were the time to therapy discontinuation, drug adherence, and drug and other health care costs. Among 10,442 RA patients identified, 36.5% swapped to a non-TNFi drug, most commonly abatacept (54.2%). The remaining 63.5% cycled to a second TNFi, most commonly adalimumab (41.2%). For subsequent switches of therapy, non-TNFi were more common. Patients who swapped to a non-TNFi were significantly older and had more comorbidities than those who cycled to a TNFi (P < 0.001). Survival analysis showed a longer time to discontinuation for non-TNFi than for TNFi (median 605 days compared with 489 days; P < 0.001) when used after initial TNFi discontinuation, but no difference in subsequent switches of therapy. Although non-TNFi were less expensive for adherent patients, cycling to a TNFi was associated with lower costs overall. Even though patients are more likely to cycle to a second TNFi than swap to a non-TNFi, those who swap to a non-TNFi are more likely to persist with the therapy. However, cycling to a TNFi is the less costly strategy.
Substances chimiques
Tumor Necrosis Factor Inhibitors
0
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1461-1469Subventions
Organisme : Rheumatology Research Foundation
Informations de copyright
© 2020, American College of Rheumatology.
Références
Yazdany J, Dudley RA, Chen R, Lin GA, Tseng CW. Coverage for high-cost specialty drugs for rheumatoid arthritis in Medicare Part D. Arthritis Rheumatol 2015;67:1474-80.
Souto A, Maneiro JR, Gomez-Reino JJ. Rate of discontinuation and drug survival of biologic therapies in rheumatoid arthritis: a systematic review and meta-analysis of drug registries and health care databases. Rheumatology (Oxford) 2016;55:523-34.
Schneeweiss S, Avorn J. A review of uses of health care utilization databases for epidemiologic research on therapeutics. J Clin Epidemiol 2005;58:323-37.
Hudson M, Tascilar K, Suissa S. Comparative effectiveness research with administrative health data in rheumatoid arthritis. Nat Rev Rheumatol 2016;12:358-66.
Bonafede MM, Curtis JR, McMorrow D, Mahajan P, Chen CI. Treatment effectiveness and treatment patterns among rheumatoid arthritis patients after switching from a tumor necrosis factor inhibitor to another medication. Clinicoecon Outcomes Res 2016;8:707-15.
Harnett J, Gerber R, Gruben D, Koenig AS, Chen C. Evaluation of real-world experience with tofacitinib compared with adalimumab, etanercept, and abatacept in RA patients with 1 previous biologic DMARD: data from a U.S. administrative claims database. J Manag Care Spec Pharm 2016;22:1457-71.
Harnett J, Wiederkehr D, Gerber R, Gruben D, Koenig A, Bourret J. Real-world evaluation of TNF-inhibitor utilization in rheumatoid arthritis. J Med Econ 2016;19:91-102.
Zhou ZY, Griffith J, Du EX, Chin D, Betts KA, Ganguli A. Economic burden of switching to a non-tumor necrosis factor inhibitor versus a tumor necrosis factor inhibitor biologic therapy among patients with rheumatoid arthritis. Adv Ther 2016;33:807-23.
Wei W, Knapp K, Wang L, Chen CI, Craig GL, Ferguson K, et al. Treatment persistence and clinical outcomes of tumor necrosis factor inhibitor cycling or switching to a new mechanism of action therapy: real-world observational study of rheumatoid arthritis patients in the United States with prior tumor necrosis factor inhibitor therapy. Adv Ther 2017;34:1936-52.
Chastek B, Becker LK, Chen CI, Mahajan P, Curtis JR. Outcomes of tumor necrosis factor inhibitor cycling versus switching to a disease-modifying anti-rheumatic drug with a new mechanism of action among patients with rheumatoid arthritis. J Med Econ 2017;20:464-73.
Chastek B, Chen CI, Proudfoot C, Shinde S, Kuznik A, Wei W. Treatment persistence and healthcare costs among patients with rheumatoid arthritis changing biologics in the USA. Adv Ther 2017;34:2422-35.
Butler Quint J. Health research data for the real world: the MarketScan Databases. Ann Arbor (MI): Truven Health Analytics; 2015.
Curtis J, Schabert VF, Yeaw J, Korn J, Quach C, Harrison DJ, et al. Using a validated algorithm to evaluate the effectiveness of biologics for rheumatoid arthritis in a commercial claims database. Value Health 2013;16:A224.
Widdifield J, Bernatsky S, Paterson JM, Tu K, Ng R, Thorne JC, et al. Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists. Arthritis Care Res (Hoboken) 2013;65:1582-91.
Zhang J, Xie F, Chen L, Greenberg JD, Curtis JR. Evaluation of a methodological approach to determine timing of rheumatoid arthritis disease onset using administrative claims data. Arthritis Rheumatol 2014;66 Suppl 10.
Ng B, Aslam F, Petersen NJ, Yu HJ, Suarez-Almazor ME. Identification of rheumatoid arthritis patients using an administrative database: a Veterans Affairs study. Arthritis Care Res (Hoboken) 2012;64:1490-6.
Singh JA, Saag KG, Bridges SL Jr, Akl EA, Bannuru RR, Sullivan MC, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 2016;68:1-26.
Smolen JS, Landewe R, Breedveld FC, Buch M, Burmester G, Dougados M, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis 2014;73:492-509.
Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992;45:613-19.
Tkacz J, Ellis L, Bolge SC, Meyer R, Brady BL, Ruetsch C. Utilization and adherence patterns of subcutaneously administered anti-tumor necrosis factor treatment among rheumatoid arthritis patients. Clin Ther 2014;36:737-47.
Johnston S, McMorrow D, Farr AM, Juneau P, Ogale S. Comparison of healthcare costs between rheumatoid arthritis patients treated with infused biologics after switching from another biologic. Drugs Real World Outcomes 2015;2:99-109.
Kievit W, Fransen J, Adang EM, den Broeder AA, Bernelot Moens HJ, Visser H, et al. Long-term effectiveness and safety of TNF-blocking agents in daily clinical practice: results from the Dutch Rheumatoid Arthritis Monitoring register. Rheumatology (Oxford) 2011;50:196-203.
Bonafede M, Fox KM, Watson C, Princic N, Gandra SR. Treatment patterns in the first year after initiating tumor necrosis factor blockers in real-world settings. Adv Ther 2012;29:664-78.
Bonafede M, Johnson BH, Princic N, Shah N, Harrison DJ. Cost per patient-year in response using a claims-based algorithm for the 2 years following biologic initiation in patients with rheumatoid arthritis. J Med Econ 2015;18:376-89.
Bonafede M, Joseph GJ, Shah N, Princic N, Harrison DJ. Cost of tumor necrosis factor blockers per patient with rheumatoid arthritis in a multistate medicaid population. Clinicoecon Outcomes Res 2014;6:381-8.
Bonafede MM, Gandra SR, Watson C, Princic N, Fox KM. Cost per treated patient for etanercept, adalimumab, and infliximab across adult indications: a claims analysis. Adv Ther 2012;29:234-48.
Borah BJ, Huang X, Zarotsky V, Globe D. Trends in RA patients' adherence to subcutaneous anti-TNF therapies and costs. Curr Med Res Opin 2009;25:1365-77.
Ogale S, Hitraya E, Henk HJ. Patterns of biologic agent utilization among patients with rheumatoid arthritis: a retrospective cohort study. BMC Musculoskelet Disord 2011;12:204.
Yazici Y, Krasnokutsky S, Barnes JP, Hines PL, Wang J, Rosenblatt L. Changing patterns of tumor necrosis factor inhibitor use in 9074 patients with rheumatoid arthritis. J Rheumatol 2009;36:907-13.
Schabert VF, Watson C, Joseph GJ, Iversen P, Burudpakdee C, Harrison DJ. Costs of tumor necrosis factor blockers per treated patient using real-world drug data in a managed care population. J Manag Care Pharm 2013;19:621-30.
Gomez-Puerta JA, Hernandez MV, Sanchez-Alonso F, Yoshida K, Sanmarti R, Solomon DH, et al. Predictors of discontinuation of biologic DMARD therapy due to remission in patients with rheumatoid arthritis in a national registry. Arthritis Rheumatol 2014;66 Suppl 10.
Yeaw J, Watson C, Fox KM, Schabert VF, Goodman S, Gandra SR. Treatment patterns following discontinuation of adalimumab, etanercept, and infliximab in a US managed care sample. Adv Ther 2014;31:410-25.
Bonafede M, Watson C, Fox KM, Princic N, Gandra SR. Tumor necrosis factor blocker treatment patterns after discontinuation within the first year of therapy initiation in rheumatoid arthritis patients in a real-world managed care setting. Arthritis Rheum 2011;63 Suppl 10.
Schmeichel-Mueller C, Buysman E, Bolge S, Ingham M, McKenzie RS. Definitions of anti-TNF discontinuation may impact understanding of real-world utilization patterns. Value Health 2011;14:A71.
Steiner JF. Measuring adherence with medications: time is of the essence. Pharmacoepidemiol Drug Saf 2016;25:333-5.
Popp RA, Rascati K, Davis M, Patel U. Refining a claims-based algorithm to estimate biologic medication effectiveness and cost per effectively treated patient with rheumatoid arthritis. Pharmacotherapy 2018;38:172-80.
United States Bureau of Labor. U.S. Bureau of Labor’s Medical Consumer Price Index. Washington DC: United States Bureau of Labor; 2017. URL: https://beta.bls.gov/dataViewer/view.
Wilke T, Mueller S, Lee SC, Majer I, Heisen M. Drug survival of second biological DMARD therapy in patients with rheumatoid arthritis: a retrospective non-interventional cohort analysis. BMC Musculoskelet Disord 2017;18:332.
Choquette D, Bessette L, Alemao E, Haraoui B, Postema R, Raynauld JP, et al. Persistence rates of abatacept and TNF inhibitors used as first or second biologic DMARDs in the treatment of rheumatoid arthritis: 9 years of experience from the Rhumadata(R) clinical database and registry. Arthritis Res Ther 2019;21:138.
Ramiro S, Landewe R, van der Heijde D, Harrison D, Collier D, Michaud K. Discontinuation rates of biologics in patients with rheumatoid arthritis: are TNF inhibitors different from non-TNF inhibitors? RMD Open 2015;1:e000155.
Favalli EG, Biggioggero M, Marchesoni A, Meroni PL. Survival on treatment with second-line biologic therapy: a cohort study comparing cycling and swap strategies. Rheumatology (Oxford) 2014;53:1664-8.
Markenson JA, Gibofsky A, Palmer WR, Keystone EC, Schiff MH, Feng J, et al. Persistence with anti-tumor necrosis factor therapies in patients with rheumatoid arthritis: observations from the RADIUS registry. J Rheumatol 2011;38:1273-81.
Meissner B, Trivedi D, You M, Rosenblatt L. Switching of biologic disease modifying anti-rheumatic drugs in patients with rheumatoid arthritis in a real world setting. J Med Econ 2014;17:259-65.
Fisher A, Bassett K, Wright JM, Brookhart MA, Freeman H, Dormuth CR. Comparative persistence of the TNF antagonists in rheumatoid arthritis: a population-based cohort study. PLoS One 2014;9:e105193.
Zhang J, Shan Y, Reed G, Kremer J, Greenberg JD, Baumgartner S, et al. Thresholds in disease activity for switching biologics in rheumatoid arthritis patients: experience from a large US cohort. Arthritis Care Res (Hoboken) 2011;63:1672-9.
Gomez-Reino JJ, Rodriguez-Lozano C, Campos-Fernandez C, Montoro M, Descalzo MA, Carmona L, et al. Change in the discontinuation pattern of tumour necrosis factor antagonists in rheumatoid arthritis over 10 years: data from the Spanish registry BIOBADASER 2.0. Ann Rheum Dis 2012;71:382-5.
Zhang J, Xie F, Delzell E, Chen L, Kilgore ML, Yun H, et al. Trends in the use of biologic agents among rheumatoid arthritis patients enrolled in the US Medicare program. Arthritis Care Res (Hoboken) 2013;65:1743-51.