Abstract
Objective Comorbidity burden and obesity may affect treatment response in patients with rheumatoid arthritis (RA). Few real-world studies have evaluated the effect of comorbidity burden or obesity on the effectiveness of tocilizumab (TCZ). This study evaluated TCZ effectiveness in treating RA patients with high versus low comorbidity burden and obesity versus nonobesity in US clinical practice.
Methods Patients in the Corrona RA registry who initiated TCZ were stratified by low or high comorbidity burden using a modified Charlson Comorbidity Index (mCCI) and by obese or nonobese status using body mass index (BMI). Improvements in disease activity and functionality after TCZ initiation were compared for the above strata of patients at 6 and 12 months after adjusting for statistically significant differences in baseline characteristics.
Results We identified patients with high (mCCI ≥ 2; n = 195) and low (mCCI < 2; n = 575) comorbidity burden and patients categorized as obese (BMI ≥ 30; n = 356) and nonobese (BMI < 30; n = 449) who were treated with TCZ. Most patients (> 95%) were biologic experienced and about one-third of patients received TCZ as monotherapy, with no significant differences between patients by comorbidity burden or obesity status. Improvement in disease activity and functionality at 6 and 12 months was similar between groups, regardless of comorbidity burden or obesity status.
Conclusion In this real-world analysis, TCZ was frequently used to treat patients with high comorbidity burden or obesity. Effectiveness of TCZ did not differ by comorbidity or obesity status.
Footnotes
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This study is sponsored by Corrona, LLC. Corrona, LLC has been supported through contracted subscriptions in the last 2 years by AbbVie, Amgen, Bristol-Myers Squibb, Crescendo, Eli Lilly and Co., Genentech, GSK, Horizon Pharma USA, Janssen, Momenta Pharmaceuticals, Novartis, Pfizer, Roche, and UCB. The study design and conduct were the result of a collaborative effort between Corrona, LLC and Genentech, Inc., and financial support for the study was provided by Genentech, Inc., which manufactures tocilizumab. Genentech, Inc. participated in the interpretation of data, review, and approval of the manuscript. All authors had full access to all the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis.
D.A. Pappas is an employee of Corrona, LLC, a consultant for AbbVie, and has received grant support from AbbVie. C.J. Etzel is an employee and shareholder of Corrona, LLC, and is a member of an advisory board for Merck. M. Crabtree is an employee of Corrona, LLC. J. Best and S. Zlotnick are employees and shareholders of Genentech, Inc. J.M. Kremer is an employee and shareholder of Corrona, LLC, and a consultant for AbbVie, Amgen, Bristol-Myers Squibb, Genentech, GlaxoSmithKline, Lilly, Pfizer, Regeneron, and Sanofi.
- Accepted for publication December 12, 2019.
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