Skip to main content
Erschienen in: Clinical Rheumatology 5/2024

06.01.2024 | ORIGINAL ARTICLE

Effectiveness and safety of sarilumab in patients with rheumatoid arthritis: A multicenter, retrospective, inverse probability of treatment-weighted analysis based on the FRAB-registry

verfasst von: Hiroshi Harada, Masakazu Kondo, Akira Maeyama, Takaaki Fukuda, Satoshi Ikemura, Eisuke Shono, Tomomi Tsuru, Yasushi Inoue, Seiji Yoshizawa, Hiroaki Niiro, Yasuharu Nakashima

Erschienen in: Clinical Rheumatology | Ausgabe 5/2024

Einloggen, um Zugang zu erhalten

Abstract

Objective

The efficacy and safety of sarilumab (SARI) were investigated in real-world clinical practice in Japan.

Method

Subjects were 121 rheumatoid arthritis (RA) patients in 23 medical institutions in Fukuoka Prefecture, Japan, who started treatment with SARI between May 2018 and November 2021. Data on the SARI starting dose, patients’ baseline characteristics, disease activity, and blood test data at the start of treatment, as well as follow-up data on the SARI dose, disease activity, and adverse events until Week 52. Safety and the continuation rate calculated by the Kaplan–Meier method were evaluated, and the effectiveness of treatment at 1 year was assessed using the clinical disease activity index (CDAI). Patients’ baseline characteristics for which significant differences were evident were adjusted with a propensity score by using the inverse probability of treatment-weighting (IPTW) method.

Results

The continuation rate at Week 52 was 66.1%. The CDAI showed significant improvement from Week 4 that was maintained until Week 52. Comparisons conducted after IPTW adjustment for patients’ baseline characteristics for which significant differences were evident revealed no significant differences at Week 52 between the groups classified by higher or lower body mass index (BMI) (p = 0.231), serious comorbidities (p = 0.973), MTX use (p = 0.321), or prior treatment with ≤ 1 or ≥ 2 biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) (p = 0.765).

Conclusions

The results showed that the efficacy of SARI is not affected by BMI, comorbidities, MTX use, or the number of prior b/tsDMARDs, and no new safety concerns were apparent.
Key Points
This is the first real-world clinical study to report on the efficacy and safety of SARI in Japan. The results of this study indicate that the efficacy of SARI was not affected by BMI, comorbidities, MTX use, or number of previous b/tsDMARDs.
It was shown that SARI can be used in a Japanese population without any new side effects.
Literatur
1.
Zurück zum Zitat Genovese MC, Fleischmann R, Kivitz A, Lee EB, van Hoogstraten H, Kimura T, St John G, Mangan EK, Burmester GR (2020) Efficacy and safety of sarilumab in combination with csDMARDs or as monotherapy in subpopulations of patients with moderately to severely active rheumatoid arthritis in three phase III randomized, controlled studies. Arthritis Res Ther 22(1):139. https://doi.org/10.1186/s13075-020-02194-zCrossRefPubMedPubMedCentral Genovese MC, Fleischmann R, Kivitz A, Lee EB, van Hoogstraten H, Kimura T, St John G, Mangan EK, Burmester GR (2020) Efficacy and safety of sarilumab in combination with csDMARDs or as monotherapy in subpopulations of patients with moderately to severely active rheumatoid arthritis in three phase III randomized, controlled studies. Arthritis Res Ther 22(1):139. https://​doi.​org/​10.​1186/​s13075-020-02194-zCrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Nakajima A, Inoue E, Shimizu Y, Kobayashi A, Shidara K, Sugimoto N, Seto Y, Tanaka E, Taniguchi A, Momohara S, Yamanaka H (2015) Presence of comorbidity affects both treatment strategies and outcomes in disease activity, physical function, and quality of life in patients with rheumatoid arthritis. Clin Rheumatol 34(3):441–449. https://doi.org/10.1007/s10067-014-2750-8CrossRefPubMed Nakajima A, Inoue E, Shimizu Y, Kobayashi A, Shidara K, Sugimoto N, Seto Y, Tanaka E, Taniguchi A, Momohara S, Yamanaka H (2015) Presence of comorbidity affects both treatment strategies and outcomes in disease activity, physical function, and quality of life in patients with rheumatoid arthritis. Clin Rheumatol 34(3):441–449. https://​doi.​org/​10.​1007/​s10067-014-2750-8CrossRefPubMed
3.
Zurück zum Zitat Dougados M, Kissel K, Sheeran T, Tak PP, Conaghan PG, Mola EM, Schett G, Amital H, Navarro-Sarabia F, Hou A, Bernasconi C, Huizinga TWJ (2013) Adding tocilizumab or switching to tocilizumab monotherapy in methotrexate inadequate responders: 24-week symptomatic and structural results of a 2-year randomised controlled strategy trial in rheumatoid arthritis (ACT-RAY). Ann Rheum Dis 72(1):43–50. https://doi.org/10.1136/annrheumdis-2011-201282CrossRefPubMed Dougados M, Kissel K, Sheeran T, Tak PP, Conaghan PG, Mola EM, Schett G, Amital H, Navarro-Sarabia F, Hou A, Bernasconi C, Huizinga TWJ (2013) Adding tocilizumab or switching to tocilizumab monotherapy in methotrexate inadequate responders: 24-week symptomatic and structural results of a 2-year randomised controlled strategy trial in rheumatoid arthritis (ACT-RAY). Ann Rheum Dis 72(1):43–50. https://​doi.​org/​10.​1136/​annrheumdis-2011-201282CrossRefPubMed
4.
Zurück zum Zitat Dougados M, Kissel K, Conaghan PG, Mola EM, Schett G, Gerli R, Hansen MS, Amital H, Xavier RM, Troum O, Bernasconi C, Huizinga TWJ (2014) Clinical, radiographic and immunogenic effects after 1 year of tocilizumab-based treatment strategies in rheumatoid arthritis: the ACT-RAY study. Ann Rheum Dis 73(5):803–809. https://doi.org/10.1136/annrheumdis-2013-204761CrossRefPubMed Dougados M, Kissel K, Conaghan PG, Mola EM, Schett G, Gerli R, Hansen MS, Amital H, Xavier RM, Troum O, Bernasconi C, Huizinga TWJ (2014) Clinical, radiographic and immunogenic effects after 1 year of tocilizumab-based treatment strategies in rheumatoid arthritis: the ACT-RAY study. Ann Rheum Dis 73(5):803–809. https://​doi.​org/​10.​1136/​annrheumdis-2013-204761CrossRefPubMed
6.
Zurück zum Zitat Huizinga TWJ, Fleischmann RM, Jasson M, Radin AR, van Adelsberg J, Fiore S, Huang X, Yancopoulos GD, Stahl N, Genovese MC (2014) Sarilumab, a fully human monoclonal antibody against IL-6Rα in patients with rheumatoid arthritis and an inadequate response to methotrexate: efficacy and safety results from the randomised SARIL-RA-MOBILITY Part A trial. Ann Rheum Dis 73(9):1626–1634. https://doi.org/10.1136/annrheumdis-2013-204405CrossRefPubMed Huizinga TWJ, Fleischmann RM, Jasson M, Radin AR, van Adelsberg J, Fiore S, Huang X, Yancopoulos GD, Stahl N, Genovese MC (2014) Sarilumab, a fully human monoclonal antibody against IL-6Rα in patients with rheumatoid arthritis and an inadequate response to methotrexate: efficacy and safety results from the randomised SARIL-RA-MOBILITY Part A trial. Ann Rheum Dis 73(9):1626–1634. https://​doi.​org/​10.​1136/​annrheumdis-2013-204405CrossRefPubMed
9.
Zurück zum Zitat Nagy G, Roodenrijs NMT, Welsing PM, Kedves M, Hamar A, van der Goes MC, Kent A, Bakkers M, Blaas E, Senolt L, Szekanecz A, Choy E, Dougados M, Jacobs JW, Geenen R, Bijlsma HW, Zink A, Aletaha D, Schoneveld L, van Riel P, Gutermann L, Prior Y, Nikiphorou E, Ferraccioli G, Schett G, Hyrich KL, Mueller-Ladner U, Buch MH, McInnes IB, van der Heijde D, van Laar JM (2021) EULAR definition of difficult-to-treat rheumatoid arthritis. Ann Rheum Dis. 80(1):31–35. https://doi.org/10.1136/annrheumdis-2020-217344CrossRefPubMed Nagy G, Roodenrijs NMT, Welsing PM, Kedves M, Hamar A, van der Goes MC, Kent A, Bakkers M, Blaas E, Senolt L, Szekanecz A, Choy E, Dougados M, Jacobs JW, Geenen R, Bijlsma HW, Zink A, Aletaha D, Schoneveld L, van Riel P, Gutermann L, Prior Y, Nikiphorou E, Ferraccioli G, Schett G, Hyrich KL, Mueller-Ladner U, Buch MH, McInnes IB, van der Heijde D, van Laar JM (2021) EULAR definition of difficult-to-treat rheumatoid arthritis. Ann Rheum Dis. 80(1):31–35. https://​doi.​org/​10.​1136/​annrheumdis-2020-217344CrossRefPubMed
11.
Zurück zum Zitat Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, Januel JM, Sundararajan V (2011) Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 173(6):676–682. https://doi.org/10.1093/aje/kwq433CrossRefPubMed Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, Januel JM, Sundararajan V (2011) Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 173(6):676–682. https://​doi.​org/​10.​1093/​aje/​kwq433CrossRefPubMed
13.
Zurück zum Zitat Ogata A, Tanimura K, Sugimoto T, Inoue H, Urata Y, Matsubara T, Kondo M, Ueki Y, Iwahashi M, Tohma S, Ohta S, Saeki Y, Tanaka T, Musashi Study Investigators (2014) Phase III study of the efficacy and safety of subcutaneous versus intravenous tocilizumab monotherapy in patients with rheumatoid arthritis. Arthritis Care Res (Hoboken). 66(3):344–354. https://doi.org/10.1002/acr.22110CrossRefPubMedPubMedCentral Ogata A, Tanimura K, Sugimoto T, Inoue H, Urata Y, Matsubara T, Kondo M, Ueki Y, Iwahashi M, Tohma S, Ohta S, Saeki Y, Tanaka T, Musashi Study Investigators (2014) Phase III study of the efficacy and safety of subcutaneous versus intravenous tocilizumab monotherapy in patients with rheumatoid arthritis. Arthritis Care Res (Hoboken). 66(3):344–354. https://​doi.​org/​10.​1002/​acr.​22110CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Kivitz A, Olech E, Borofsky M, Zazueta BM, Navarro-Sarabia F, Radominski SC, Merrill JT, Rowell L, Nasmyth-Miller C, Bao M, Wright S, Pope JE (2014) Subcutaneous Tocilizumab Versus Placebo in Combination With Disease-Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 66(11):1653–1661. https://doi.org/10.1002/acr.22384CrossRefPubMed Kivitz A, Olech E, Borofsky M, Zazueta BM, Navarro-Sarabia F, Radominski SC, Merrill JT, Rowell L, Nasmyth-Miller C, Bao M, Wright S, Pope JE (2014) Subcutaneous Tocilizumab Versus Placebo in Combination With Disease-Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 66(11):1653–1661. https://​doi.​org/​10.​1002/​acr.​22384CrossRefPubMed
15.
Zurück zum Zitat Genovese MC, Fleischmann R, Kivitz AJ, Rell-Bakalarska M, Martincova R, Fiore S, Rohane P, van Hoogstraten H, Garg A, Fan C, van Adelsberg J, Weinstein SP, Graham NMH, Stahl N, Yancopoulos GD, Huizinga TWJ, van der Heijde D (2015) Sarilumab Plus Methotrexate in Patients With Active Rheumatoid Arthritis and Inadequate Response to Methotrexate: Results of a Phase III Study. Arthritis Rheumatol 67(6):1424–1437. https://doi.org/10.1002/art.39093CrossRefPubMed Genovese MC, Fleischmann R, Kivitz AJ, Rell-Bakalarska M, Martincova R, Fiore S, Rohane P, van Hoogstraten H, Garg A, Fan C, van Adelsberg J, Weinstein SP, Graham NMH, Stahl N, Yancopoulos GD, Huizinga TWJ, van der Heijde D (2015) Sarilumab Plus Methotrexate in Patients With Active Rheumatoid Arthritis and Inadequate Response to Methotrexate: Results of a Phase III Study. Arthritis Rheumatol 67(6):1424–1437. https://​doi.​org/​10.​1002/​art.​39093CrossRefPubMed
18.
Zurück zum Zitat Fleischmann R, Genovese MC, Lin Y, St John G, van der Heijde D, Wang S, Gomez-Reino JJ, Maldonado-Cocco JA, Stanislav M, Kivitz AJ, Burmester GR (2020) Long-term safety of sarilumab in rheumatoid arthritis: an integrated analysis with up to 7 years’ follow-up. Rheumatology (Oxford) 59(2):292–302. https://doi.org/10.1093/rheumatology/kez265CrossRefPubMed Fleischmann R, Genovese MC, Lin Y, St John G, van der Heijde D, Wang S, Gomez-Reino JJ, Maldonado-Cocco JA, Stanislav M, Kivitz AJ, Burmester GR (2020) Long-term safety of sarilumab in rheumatoid arthritis: an integrated analysis with up to 7 years’ follow-up. Rheumatology (Oxford) 59(2):292–302. https://​doi.​org/​10.​1093/​rheumatology/​kez265CrossRefPubMed
20.
Zurück zum Zitat Fleischmann R, van Delsberg AJ, Lin Y, Castelar-Pinheiro CR, Brzezicki J, Hrycaj P, Neil MH, Graham NMH, van Hoogstraten H, Bauer D, Burmester GR (2017) Sarilumab and Nonbiologic Disease-Modifying Antirheumatic Drugs in Patients With Active Rheumatoid Arthritis and Inadequate Response or Intolerance to Tumor Necrosis Factor Inhibitors. Arthritis Rheumatol. 69(2):277–290. https://doi.org/10.1002/art.39944CrossRefPubMedPubMedCentral Fleischmann R, van Delsberg AJ, Lin Y, Castelar-Pinheiro CR, Brzezicki J, Hrycaj P, Neil MH, Graham NMH, van Hoogstraten H, Bauer D, Burmester GR (2017) Sarilumab and Nonbiologic Disease-Modifying Antirheumatic Drugs in Patients With Active Rheumatoid Arthritis and Inadequate Response or Intolerance to Tumor Necrosis Factor Inhibitors. Arthritis Rheumatol. 69(2):277–290. https://​doi.​org/​10.​1002/​art.​39944CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Tony HP, Feist E, Aries PM, Zinke S, Kruger K, Ahlers J, Albrecht I, Barrionuevo C, Kalus S, Burkhardt H (2022) Sarilumab reduces disease activity in rheumatoid arthritis patients with inadequate response to janus kinase inhibitors or tocilizumab in regular care in Germany. Rheumatology Advances in Practice 00:1–7. https://doi.org/10.1093/rap/rkac002CrossRef Tony HP, Feist E, Aries PM, Zinke S, Kruger K, Ahlers J, Albrecht I, Barrionuevo C, Kalus S, Burkhardt H (2022) Sarilumab reduces disease activity in rheumatoid arthritis patients with inadequate response to janus kinase inhibitors or tocilizumab in regular care in Germany. Rheumatology Advances in Practice 00:1–7. https://​doi.​org/​10.​1093/​rap/​rkac002CrossRef
Metadaten
Titel
Effectiveness and safety of sarilumab in patients with rheumatoid arthritis: A multicenter, retrospective, inverse probability of treatment-weighted analysis based on the FRAB-registry
verfasst von
Hiroshi Harada
Masakazu Kondo
Akira Maeyama
Takaaki Fukuda
Satoshi Ikemura
Eisuke Shono
Tomomi Tsuru
Yasushi Inoue
Seiji Yoshizawa
Hiroaki Niiro
Yasuharu Nakashima
Publikationsdatum
06.01.2024
Verlag
Springer International Publishing
Erschienen in
Clinical Rheumatology / Ausgabe 5/2024
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-023-06862-8

Weitere Artikel der Ausgabe 5/2024

Clinical Rheumatology 5/2024 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.