Two-year clinical outcomes after discontinuation of long-term golimumab therapy in Korean patients with rheumatoid arthritis
- Author:
Kichul SHIN
1
;
Hyun Mi KWON
;
Min Jung KIM
;
Myung Jae YOON
;
Hyun Gyung CHAI
;
Seong-Wook KANG
;
Won PARK
;
Sung-Hwan PARK
;
Chang Hee SUH
;
Hyun Ah KIM
;
Seung-Geun LEE
;
Choong Ki LEE
;
Sang-Cheol BAE
;
Yong-Beom PARK
;
Yeong Wook SONG
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2022;37(5):1061-1069
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:The aim of this study was to investigate long-term post-discontinuation outcomes in patients with rheumatoid arthritis (RA) who had been treated with tumor necrosis factor-α inhibitors (TNF-αi) which was then discontinued.
Methods:Sixty Korean patients with RA who participated in a 5-year GO-BEFORE and GO-FORWARD extension trials were included in this retrospective study. Golimumab was deliberately discontinued after the extension study (baseline). Patients were then followed by their rheumatologists. We reviewed their medical records for 2 years (max 28 months) following golimumab discontinuation. Patients were divided into a maintained benefit (MB) group and a loss-of-benefit (LB) group based on treatment pattern after golimumab discontinuation. The LB group included patients whose conventional disease-modifying antirheumatic drug(s) were stepped-up or added/switched (SC) and those who restarted biologic therapy (RB).
Results:The mean age of patients at baseline was 56.5 years and 55 (91.7%) were females. At the end of follow-up, 23 (38.3%) patients remained in the MB group. In the LB group, 75.7% and 24.3% were assigned into SC and RB subgroups, respectively. Fifty percent of patients lost MB after 23.3 months. Demographics and clinical variables at baseline were comparable between MB and LB groups except for age, C-reactive protein level, and corticosteroid use. Restarting biologic therapy was associated with swollen joint count (adjusted hazard ratio [HR], 1.90; 95% confidence interval [CI], 1.01 to 3.55) and disease duration (adjusted HR, 1.12; 95% CI, 1.02 to 1.23) at baseline.
Conclusions:Treatment strategies after discontinuing TNF-αi are needed to better maintain disease control and quality of life of patients with RA.
