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Switching profiles in a population-based cohort of rheumatoid arthritis receiving biologic therapy: results from the KOBIO registry

 Dong-Jin Park  ;  Sung Jae Choi  ;  Kichul Shin  ;  Hyoun-Ah Kim  ;  Yong-Beom Park  ;  Seong Wook Kang  ;  Seung-Ki Kwok  ;  Seong-Kyu Kim  ;  Eon Jeong Nam  ;  Yoon-Kyoung Sung  ;  Jaejoon Lee  ;  Chang Hoon Lee  ;  Chan Hong Jeon  ;  Shin-Seok Lee 
 CLINICAL RHEUMATOLOGY, Vol.36(5) : 1013-1022, 2017 
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Arthritis, Rheumatoid/blood ; Arthritis, Rheumatoid/drug therapy* ; Biological Products/therapeutic use* ; Biological Therapy/methods* ; C-Reactive Protein/metabolism ; Drug Substitution ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Registries* ; Republic of Korea ; Time Factors ; Treatment Outcome
Biologic agents ; Registry ; Rheumatoid arthritis ; Switching
Despite improved quality of care for rheumatoid arthritis (RA) patients, many still experience treatment failure with a biologic agent and eventually switch to another biologic agent. We investigated patterns of biologic treatment and reasons for switching biologics in patients with RA. Patients with RA who had started on a biologic agent or had switched to another biologic agent were identified from the prospective observational Korean nationwide Biologics (KOBIO) registry. The KOBIO registry contained 1184 patients with RA at the time of initiation or switching of biologic agents. Patients were categorized according to the chronological order of the introduction of biologic agents, and reasons for switching biologics were also evaluated. Of the 1184 patients with RA, 801 started with their first biologic agent, 228 were first-time switchers, and 89 were second-time or more switchers. Second-time or more switchers had lower rheumatoid factor and anti-CCP positivity, and higher disease activity scores at the time of enrollment than the other groups. Among these patients, tocilizumab was the most commonly prescribed biologic agent, followed by adalimumab and etanercept. The most common reason for switching biologics was inefficacy, followed by adverse events, including infusion reactions, infections, and skin eruptions. Furthermore, the proportion of inefficacy, as a reason for switching, was significantly higher with respect to switching between biologics with different mechanisms of action than between biologics with similar mechanisms. In this registry, we showed diverse prescribing patterns and differing baseline profiles based on the chronological order of biologic agents.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
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