Korean J Intern Med.
2022 Sep;37(5):1061-1069. 10.3904/kjim.2021.018.
Two-year clinical outcomes after discontinuation of long-term golimumab therapy in Korean patients with rheumatoid arthritis
- Shin K1
- Kwon HM2
- Kim MJ1
- Yoon MJ2
- Chai HG2
- Kang SW3
- Park W4
- Park SH5
- Suh CH6
- Kim HA7
- Lee SG8
- Lee CK9
- Bae SC10
- Park YB11
- Song YW
2,12
- Affiliations
-
- 1Division of Rheumatology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- 2Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- 3Division of Rheumatology, Chungnam National University Hospital, Daejeon, Korea
- 4Division of Rheumatology, Inha University Hospital, Incheon, Korea
- 5Division of Rheumatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 6Division of Rheumatology, Ajou University Hospital, Suwon, Korea
- 7Division of Rheumatology, Hallym University Sacred Heart Hospital, Anyang, Korea
- 8Division of Rheumatology, Pusan National University Hospital, Busan, Korea
- 9Division of Rheumatology, Yeungnam University Medical Center, Daegu, Korea
- 10Division of Rheumatology, Hanyang University Seoul Hospital, Seoul, Korea
- 11Division of Rheumatology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 12Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Center, Seoul National University, Seoul, Korea
- KMID: 2533148
- DOI: http://doi.org/10.3904/kjim.2021.018
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.
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