Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: Results from the international TOCERRA and PANABA observational collaborative studies

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Standard

Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept : Results from the international TOCERRA and PANABA observational collaborative studies. / Lauper, Kim; Mongin, Denis; Bergstra, Sytske Anne; Choquette, Denis; Codreanu, Catalin; Gottenberg, Jacques Eric; Kubo, Satoshi; Hetland, Merete Lund; Iannone, Florenzo; Kristianslund, Eirik K.; Kvien, Tore K.; Lukina, Galina; Mariette, Xavier; Nordström, Dan C.; Pavelka, Karel; Pombo-Suarez, Manuel; Rotar, Ziga; Santos, Maria J.; Tanaka, Yoshiya; Turesson, Carl; Courvoisier, Delphine S.; Finckh, Axel; Gabay, Cem.

I: Joint Bone Spine, Bind 91, Nr. 2, 105671, 2024.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Lauper, K, Mongin, D, Bergstra, SA, Choquette, D, Codreanu, C, Gottenberg, JE, Kubo, S, Hetland, ML, Iannone, F, Kristianslund, EK, Kvien, TK, Lukina, G, Mariette, X, Nordström, DC, Pavelka, K, Pombo-Suarez, M, Rotar, Z, Santos, MJ, Tanaka, Y, Turesson, C, Courvoisier, DS, Finckh, A & Gabay, C 2024, 'Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: Results from the international TOCERRA and PANABA observational collaborative studies', Joint Bone Spine, bind 91, nr. 2, 105671. https://doi.org/10.1016/j.jbspin.2023.105671

APA

Lauper, K., Mongin, D., Bergstra, S. A., Choquette, D., Codreanu, C., Gottenberg, J. E., Kubo, S., Hetland, M. L., Iannone, F., Kristianslund, E. K., Kvien, T. K., Lukina, G., Mariette, X., Nordström, D. C., Pavelka, K., Pombo-Suarez, M., Rotar, Z., Santos, M. J., Tanaka, Y., ... Gabay, C. (2024). Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: Results from the international TOCERRA and PANABA observational collaborative studies. Joint Bone Spine, 91(2), [105671]. https://doi.org/10.1016/j.jbspin.2023.105671

Vancouver

Lauper K, Mongin D, Bergstra SA, Choquette D, Codreanu C, Gottenberg JE o.a. Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: Results from the international TOCERRA and PANABA observational collaborative studies. Joint Bone Spine. 2024;91(2). 105671. https://doi.org/10.1016/j.jbspin.2023.105671

Author

Lauper, Kim ; Mongin, Denis ; Bergstra, Sytske Anne ; Choquette, Denis ; Codreanu, Catalin ; Gottenberg, Jacques Eric ; Kubo, Satoshi ; Hetland, Merete Lund ; Iannone, Florenzo ; Kristianslund, Eirik K. ; Kvien, Tore K. ; Lukina, Galina ; Mariette, Xavier ; Nordström, Dan C. ; Pavelka, Karel ; Pombo-Suarez, Manuel ; Rotar, Ziga ; Santos, Maria J. ; Tanaka, Yoshiya ; Turesson, Carl ; Courvoisier, Delphine S. ; Finckh, Axel ; Gabay, Cem. / Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept : Results from the international TOCERRA and PANABA observational collaborative studies. I: Joint Bone Spine. 2024 ; Bind 91, Nr. 2.

Bibtex

@article{8ec5d2f608304847a17b4b7a9fc9acf9,
title = "Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept: Results from the international TOCERRA and PANABA observational collaborative studies",
abstract = "Objective: To evaluate and compare the use of oral glucocorticoids with three classes of bDMARDs in patients with rheumatoid arthritis (RA). Methods: We included patients from 13 observational registries treated with a TNF-inhibitor, abatacept or tocilizumab and with available information on the use of oral glucocorticoids. The main outcome was oral glucocorticoid withdrawal. A McNemar test was used to analyse the change in the use of glucocorticoids after 1 year. Kaplan-Meier estimates and Cox regressions, adjusted for patient, treatment, and disease characteristics, were used to evaluate glucocorticoid discontinuation in patients with glucocorticoids at baseline. Because of heterogeneity, analyses were done by registers and pooled using random-effects meta-analysis. Results: A total of 12,334 participants treated with TNF-inhibitors, 2100 with tocilizumab and 3229 with abatacept were included. At one-year, oral glucocorticoid use decreased in all treatment groups (odds ratio for stopping vs. starting of 2.19 [95% CI 1.58; 3.04] for TNF-inhibitors, 2.46 [1.39; 4.35] for tocilizumab; 1.73 [1.25; 2.21] for abatacept). Median time to glucocorticoid withdrawal was ≈2 years or more in most countries, with a gradual decrease over time. Compared to TNF-inhibitors, crude hazard ratios of glucocorticoid discontinuation were 0.65[0.48–0.87] for abatacept, and 1.04 [0.76–1.43] for tocilizumab, and adjusted hazard ratios were 1.1 [0.83–1.47] for abatacept, and 1.30 [0.96–1.78] for tocilizumab. Conclusion: After initiation of a bDMARD, glucocorticoid use decreased similarly in all treatment groups. However, glucocorticoid withdrawal was much slower than advocated by current international guidelines. More effort should be devoted to glucocorticoid tapering when low disease activity is achieved.",
keywords = "Biologic, Corticosteroid, Epidemiology, IL-6 inhibitor, Observational, Registry",
author = "Kim Lauper and Denis Mongin and Bergstra, {Sytske Anne} and Denis Choquette and Catalin Codreanu and Gottenberg, {Jacques Eric} and Satoshi Kubo and Hetland, {Merete Lund} and Florenzo Iannone and Kristianslund, {Eirik K.} and Kvien, {Tore K.} and Galina Lukina and Xavier Mariette and Nordstr{\"o}m, {Dan C.} and Karel Pavelka and Manuel Pombo-Suarez and Ziga Rotar and Santos, {Maria J.} and Yoshiya Tanaka and Carl Turesson and Courvoisier, {Delphine S.} and Axel Finckh and Cem Gabay",
note = "Publisher Copyright: {\textcopyright} 2023 The Author(s)",
year = "2024",
doi = "10.1016/j.jbspin.2023.105671",
language = "English",
volume = "91",
journal = "Joint Bone Spine",
issn = "1297-319X",
publisher = "Elsevier Masson",
number = "2",

}

RIS

TY - JOUR

T1 - Oral glucocorticoid use in patients with rheumatoid arthritis initiating TNF-inhibitors, tocilizumab or abatacept

T2 - Results from the international TOCERRA and PANABA observational collaborative studies

AU - Lauper, Kim

AU - Mongin, Denis

AU - Bergstra, Sytske Anne

AU - Choquette, Denis

AU - Codreanu, Catalin

AU - Gottenberg, Jacques Eric

AU - Kubo, Satoshi

AU - Hetland, Merete Lund

AU - Iannone, Florenzo

AU - Kristianslund, Eirik K.

AU - Kvien, Tore K.

AU - Lukina, Galina

AU - Mariette, Xavier

AU - Nordström, Dan C.

AU - Pavelka, Karel

AU - Pombo-Suarez, Manuel

AU - Rotar, Ziga

AU - Santos, Maria J.

AU - Tanaka, Yoshiya

AU - Turesson, Carl

AU - Courvoisier, Delphine S.

AU - Finckh, Axel

AU - Gabay, Cem

N1 - Publisher Copyright: © 2023 The Author(s)

PY - 2024

Y1 - 2024

N2 - Objective: To evaluate and compare the use of oral glucocorticoids with three classes of bDMARDs in patients with rheumatoid arthritis (RA). Methods: We included patients from 13 observational registries treated with a TNF-inhibitor, abatacept or tocilizumab and with available information on the use of oral glucocorticoids. The main outcome was oral glucocorticoid withdrawal. A McNemar test was used to analyse the change in the use of glucocorticoids after 1 year. Kaplan-Meier estimates and Cox regressions, adjusted for patient, treatment, and disease characteristics, were used to evaluate glucocorticoid discontinuation in patients with glucocorticoids at baseline. Because of heterogeneity, analyses were done by registers and pooled using random-effects meta-analysis. Results: A total of 12,334 participants treated with TNF-inhibitors, 2100 with tocilizumab and 3229 with abatacept were included. At one-year, oral glucocorticoid use decreased in all treatment groups (odds ratio for stopping vs. starting of 2.19 [95% CI 1.58; 3.04] for TNF-inhibitors, 2.46 [1.39; 4.35] for tocilizumab; 1.73 [1.25; 2.21] for abatacept). Median time to glucocorticoid withdrawal was ≈2 years or more in most countries, with a gradual decrease over time. Compared to TNF-inhibitors, crude hazard ratios of glucocorticoid discontinuation were 0.65[0.48–0.87] for abatacept, and 1.04 [0.76–1.43] for tocilizumab, and adjusted hazard ratios were 1.1 [0.83–1.47] for abatacept, and 1.30 [0.96–1.78] for tocilizumab. Conclusion: After initiation of a bDMARD, glucocorticoid use decreased similarly in all treatment groups. However, glucocorticoid withdrawal was much slower than advocated by current international guidelines. More effort should be devoted to glucocorticoid tapering when low disease activity is achieved.

AB - Objective: To evaluate and compare the use of oral glucocorticoids with three classes of bDMARDs in patients with rheumatoid arthritis (RA). Methods: We included patients from 13 observational registries treated with a TNF-inhibitor, abatacept or tocilizumab and with available information on the use of oral glucocorticoids. The main outcome was oral glucocorticoid withdrawal. A McNemar test was used to analyse the change in the use of glucocorticoids after 1 year. Kaplan-Meier estimates and Cox regressions, adjusted for patient, treatment, and disease characteristics, were used to evaluate glucocorticoid discontinuation in patients with glucocorticoids at baseline. Because of heterogeneity, analyses were done by registers and pooled using random-effects meta-analysis. Results: A total of 12,334 participants treated with TNF-inhibitors, 2100 with tocilizumab and 3229 with abatacept were included. At one-year, oral glucocorticoid use decreased in all treatment groups (odds ratio for stopping vs. starting of 2.19 [95% CI 1.58; 3.04] for TNF-inhibitors, 2.46 [1.39; 4.35] for tocilizumab; 1.73 [1.25; 2.21] for abatacept). Median time to glucocorticoid withdrawal was ≈2 years or more in most countries, with a gradual decrease over time. Compared to TNF-inhibitors, crude hazard ratios of glucocorticoid discontinuation were 0.65[0.48–0.87] for abatacept, and 1.04 [0.76–1.43] for tocilizumab, and adjusted hazard ratios were 1.1 [0.83–1.47] for abatacept, and 1.30 [0.96–1.78] for tocilizumab. Conclusion: After initiation of a bDMARD, glucocorticoid use decreased similarly in all treatment groups. However, glucocorticoid withdrawal was much slower than advocated by current international guidelines. More effort should be devoted to glucocorticoid tapering when low disease activity is achieved.

KW - Biologic

KW - Corticosteroid

KW - Epidemiology

KW - IL-6 inhibitor

KW - Observational

KW - Registry

U2 - 10.1016/j.jbspin.2023.105671

DO - 10.1016/j.jbspin.2023.105671

M3 - Journal article

C2 - 38042363

AN - SCOPUS:85181255234

VL - 91

JO - Joint Bone Spine

JF - Joint Bone Spine

SN - 1297-319X

IS - 2

M1 - 105671

ER -

ID: 379713070