Long-Term Effectiveness of Adalimumab in Patients with Rheumatoid Arthritis: An Observational Analysis from the Corrona Rheumatoid Arthritis Registry

Dimitrios A Pappas; Joel M Kremer; Jenny Griffith; George Reed; Bob Salim; Chitra Karki; Vishvas Garg

doi:10.1007/s40744-017-0077-z

Long-Term Effectiveness of Adalimumab in Patients with Rheumatoid Arthritis: An Observational Analysis from the Corrona Rheumatoid Arthritis Registry

Rheumatol Ther. 2017 Dec;4(2):375-389. doi: 10.1007/s40744-017-0077-z. Epub 2017 Aug 24.

Authors

Dimitrios A Pappas^{1

2}, Joel M Kremer^{3

2}, Jenny Griffith⁴, George Reed^{5

2}, Bob Salim⁶, Chitra Karki², Vishvas Garg⁷

Affiliations

¹ Columbia University, New York, NY, USA.
² Corrona LLC, Southborough, MA, USA.
³ Albany Medical College and The Center for Rheumatology, Albany, NY, USA.
⁴ Abbvie, Inc., North Chicago, IL, USA.
⁵ UMass Medical School, Worcester, MA, USA.
⁶ Axio Research LLC, Seattle, WA, USA.
⁷ Abbvie, Inc., North Chicago, IL, USA. vishvas.garg@abbvie.com.

Abstract

Introduction: Current recommendations for the management of rheumatoid arthritis (RA) focus on a treat-to-target approach with the objective of maximizing long-term health-related quality-of-life in patients with RA. Published studies from randomized clinical trials have reported limited data regarding the long-term efficacy and safety of adalimumab in patients with RA. This study aims to evaluate the long-term (10+ years) persistency and effectiveness of adalimumab in patients with RA in a real-world setting.

Methods: Included in this study were biologic-naïve adults with RA initiating adalimumab during follow-up enrolled in the Corrona RA registry. More than 10 years of data on persistency of adalimumab and rheumatologist-supplied reasons for discontinuation were examined. Among patients who persisted on adalimumab over the years, clinical [e.g., clinical disease activity index scores (CDAI), physician global assessment, tender joint count, and swollen joint count] and patient-reported outcomes (PRO), such as physical function, pain, fatigue, and morning stiffness, were examined.

Results: Of 1791 biologic-naive patients treated with adalimumab who had ≥1 follow-up registry visit, 64.1% were still on therapy at 1 year and 10.2% were still on therapy by the end of year 12. Among patients who persisted on adalimumab for at least 1 year (77.1% female, mean age 53.9 years), 67.0% were in low disease activity (LDA)/remission (CDAI ≤10) and had clinically meaningful improvements from baseline in all clinical assessments and PROs. Initial improvements in LDA/remission and in clinical and PRO assessments observed at year 1 were sustained in those patients who remained on adalimumab over 10 years of follow-up. Among patients who discontinued adalimumab, 61.6% were not in LDA/remission and 41.9% switched to another biologic within 12 months after discontinuing adalimumab.

Conclusions: Real-world data demonstrate a sustained effectiveness of adalimumab in the treatment of RA for patients who remained on therapy for 10 years.

Funding: Corrona, LLC and AbbVie.

Keywords: Adalimumab; Biologic; Corrona; Real-world; Rheumatoid arthritis; Treat-to-target.