Effect of Concomitant Disease-modifying Antirheumatic Drugs and Methotrexate Administration Route on Biologic Treatment Durability in Rheumatoid Arthritis: OBRI Cohort Results

From McMaster University, Hamilton, Ontario; Southlake Regional Health Centre, Newmarket, Ontario; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario; JSS Medical Research; McGill University, Montreal, Quebec; University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation; Mount Sinai Hospital, Division of Rheumatology, Toronto, Ontario, Canada. OBRI was funded by peer-reviewed grants from Canadian Institute for Health Research (CIHR), Ontario Ministry of Health and Long-Term Care (MOHLTC), Canadian Arthritis Network (CAN), and unrestricted grants from AbbVie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, and UCB. MM, AC, XL, SC, and CB are employees at OBRI, which was funded by peer-reviewed grants from CIHR, MOHLTC, CAN, and unrestricted grants from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Hospital Janssen, Pfizer, Roche, Sanofi, and UCB. ER and JSS are employees at JSS Medical Research, a contract research organization. A.N. Lau, MD, McMaster University; J.C. Thorne, MD, Southlake Regional Health Centre; M. Movahedi, MD, PhD, Toronto General Hospital Research Institute, University Health Network; E. Rampakakis, PhD, JSS Medical Research; A. Cesta, BSc, Toronto General Hospital Research Institute, University Health Network; X. Li, BSc, Toronto General Hospital Research Institute, University Health Network; S. Couto, MSc, Toronto General Hospital Research Institute, University Health Network; J. Sampalis, PhD, JSS Medical Research, and McGill University; C. Bombardier, MD, Toronto General Hospital Research Institute, University Health Network, and University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation, and Mount Sinai Hospital, Division of Rheumatology. Address correspondence to Dr. A.N. Lau, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: arthur.lau@medportal.ca. Accepted for publication October 30, 2018.

From McMaster University, Hamilton, Ontario; Southlake Regional Health Centre, Newmarket, Ontario; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario; JSS Medical Research; McGill University, Montreal, Quebec; University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation; Mount Sinai Hospital, Division of Rheumatology, Toronto, Ontario, Canada. OBRI was funded by peer-reviewed grants from Canadian Institute for Health Research (CIHR), Ontario Ministry of Health and Long-Term Care (MOHLTC), Canadian Arthritis Network (CAN), and unrestricted grants from AbbVie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, and UCB. MM, AC, XL, SC, and CB are employees at OBRI, which was funded by peer-reviewed grants from CIHR, MOHLTC, CAN, and unrestricted grants from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Hospital Janssen, Pfizer, Roche, Sanofi, and UCB. ER and JSS are employees at JSS Medical Research, a contract research organization. A.N. Lau, MD, McMaster University; J.C. Thorne, MD, Southlake Regional Health Centre; M. Movahedi, MD, PhD, Toronto General Hospital Research Institute, University Health Network; E. Rampakakis, PhD, JSS Medical Research; A. Cesta, BSc, Toronto General Hospital Research Institute, University Health Network; X. Li, BSc, Toronto General Hospital Research Institute, University Health Network; S. Couto, MSc, Toronto General Hospital Research Institute, University Health Network; J. Sampalis, PhD, JSS Medical Research, and McGill University; C. Bombardier, MD, Toronto General Hospital Research Institute, University Health Network, and University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation, and Mount Sinai Hospital, Division of Rheumatology. Address correspondence to Dr. A.N. Lau, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: arthur.lau@medportal.ca. Accepted for publication October 30, 2018.

From McMaster University, Hamilton, Ontario; Southlake Regional Health Centre, Newmarket, Ontario; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario; JSS Medical Research; McGill University, Montreal, Quebec; University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation; Mount Sinai Hospital, Division of Rheumatology, Toronto, Ontario, Canada. OBRI was funded by peer-reviewed grants from Canadian Institute for Health Research (CIHR), Ontario Ministry of Health and Long-Term Care (MOHLTC), Canadian Arthritis Network (CAN), and unrestricted grants from AbbVie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, and UCB. MM, AC, XL, SC, and CB are employees at OBRI, which was funded by peer-reviewed grants from CIHR, MOHLTC, CAN, and unrestricted grants from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Hospital Janssen, Pfizer, Roche, Sanofi, and UCB. ER and JSS are employees at JSS Medical Research, a contract research organization. A.N. Lau, MD, McMaster University; J.C. Thorne, MD, Southlake Regional Health Centre; M. Movahedi, MD, PhD, Toronto General Hospital Research Institute, University Health Network; E. Rampakakis, PhD, JSS Medical Research; A. Cesta, BSc, Toronto General Hospital Research Institute, University Health Network; X. Li, BSc, Toronto General Hospital Research Institute, University Health Network; S. Couto, MSc, Toronto General Hospital Research Institute, University Health Network; J. Sampalis, PhD, JSS Medical Research, and McGill University; C. Bombardier, MD, Toronto General Hospital Research Institute, University Health Network, and University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation, and Mount Sinai Hospital, Division of Rheumatology. Address correspondence to Dr. A.N. Lau, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: arthur.lau@medportal.ca. Accepted for publication October 30, 2018.

From McMaster University, Hamilton, Ontario; Southlake Regional Health Centre, Newmarket, Ontario; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario; JSS Medical Research; McGill University, Montreal, Quebec; University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation; Mount Sinai Hospital, Division of Rheumatology, Toronto, Ontario, Canada. OBRI was funded by peer-reviewed grants from Canadian Institute for Health Research (CIHR), Ontario Ministry of Health and Long-Term Care (MOHLTC), Canadian Arthritis Network (CAN), and unrestricted grants from AbbVie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, and UCB. MM, AC, XL, SC, and CB are employees at OBRI, which was funded by peer-reviewed grants from CIHR, MOHLTC, CAN, and unrestricted grants from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Hospital Janssen, Pfizer, Roche, Sanofi, and UCB. ER and JSS are employees at JSS Medical Research, a contract research organization. A.N. Lau, MD, McMaster University; J.C. Thorne, MD, Southlake Regional Health Centre; M. Movahedi, MD, PhD, Toronto General Hospital Research Institute, University Health Network; E. Rampakakis, PhD, JSS Medical Research; A. Cesta, BSc, Toronto General Hospital Research Institute, University Health Network; X. Li, BSc, Toronto General Hospital Research Institute, University Health Network; S. Couto, MSc, Toronto General Hospital Research Institute, University Health Network; J. Sampalis, PhD, JSS Medical Research, and McGill University; C. Bombardier, MD, Toronto General Hospital Research Institute, University Health Network, and University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation, and Mount Sinai Hospital, Division of Rheumatology. Address correspondence to Dr. A.N. Lau, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: arthur.lau@medportal.ca. Accepted for publication October 30, 2018.

From McMaster University, Hamilton, Ontario; Southlake Regional Health Centre, Newmarket, Ontario; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario; JSS Medical Research; McGill University, Montreal, Quebec; University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation; Mount Sinai Hospital, Division of Rheumatology, Toronto, Ontario, Canada. OBRI was funded by peer-reviewed grants from Canadian Institute for Health Research (CIHR), Ontario Ministry of Health and Long-Term Care (MOHLTC), Canadian Arthritis Network (CAN), and unrestricted grants from AbbVie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, and UCB. MM, AC, XL, SC, and CB are employees at OBRI, which was funded by peer-reviewed grants from CIHR, MOHLTC, CAN, and unrestricted grants from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Hospital Janssen, Pfizer, Roche, Sanofi, and UCB. ER and JSS are employees at JSS Medical Research, a contract research organization. A.N. Lau, MD, McMaster University; J.C. Thorne, MD, Southlake Regional Health Centre; M. Movahedi, MD, PhD, Toronto General Hospital Research Institute, University Health Network; E. Rampakakis, PhD, JSS Medical Research; A. Cesta, BSc, Toronto General Hospital Research Institute, University Health Network; X. Li, BSc, Toronto General Hospital Research Institute, University Health Network; S. Couto, MSc, Toronto General Hospital Research Institute, University Health Network; J. Sampalis, PhD, JSS Medical Research, and McGill University; C. Bombardier, MD, Toronto General Hospital Research Institute, University Health Network, and University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation, and Mount Sinai Hospital, Division of Rheumatology. Address correspondence to Dr. A.N. Lau, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: arthur.lau@medportal.ca. Accepted for publication October 30, 2018.

From McMaster University, Hamilton, Ontario; Southlake Regional Health Centre, Newmarket, Ontario; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario; JSS Medical Research; McGill University, Montreal, Quebec; University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation; Mount Sinai Hospital, Division of Rheumatology, Toronto, Ontario, Canada. OBRI was funded by peer-reviewed grants from Canadian Institute for Health Research (CIHR), Ontario Ministry of Health and Long-Term Care (MOHLTC), Canadian Arthritis Network (CAN), and unrestricted grants from AbbVie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, and UCB. MM, AC, XL, SC, and CB are employees at OBRI, which was funded by peer-reviewed grants from CIHR, MOHLTC, CAN, and unrestricted grants from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Hospital Janssen, Pfizer, Roche, Sanofi, and UCB. ER and JSS are employees at JSS Medical Research, a contract research organization. A.N. Lau, MD, McMaster University; J.C. Thorne, MD, Southlake Regional Health Centre; M. Movahedi, MD, PhD, Toronto General Hospital Research Institute, University Health Network; E. Rampakakis, PhD, JSS Medical Research; A. Cesta, BSc, Toronto General Hospital Research Institute, University Health Network; X. Li, BSc, Toronto General Hospital Research Institute, University Health Network; S. Couto, MSc, Toronto General Hospital Research Institute, University Health Network; J. Sampalis, PhD, JSS Medical Research, and McGill University; C. Bombardier, MD, Toronto General Hospital Research Institute, University Health Network, and University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation, and Mount Sinai Hospital, Division of Rheumatology. Address correspondence to Dr. A.N. Lau, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: arthur.lau@medportal.ca. Accepted for publication October 30, 2018.

From McMaster University, Hamilton, Ontario; Southlake Regional Health Centre, Newmarket, Ontario; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario; JSS Medical Research; McGill University, Montreal, Quebec; University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation; Mount Sinai Hospital, Division of Rheumatology, Toronto, Ontario, Canada. OBRI was funded by peer-reviewed grants from Canadian Institute for Health Research (CIHR), Ontario Ministry of Health and Long-Term Care (MOHLTC), Canadian Arthritis Network (CAN), and unrestricted grants from AbbVie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, and UCB. MM, AC, XL, SC, and CB are employees at OBRI, which was funded by peer-reviewed grants from CIHR, MOHLTC, CAN, and unrestricted grants from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Hospital Janssen, Pfizer, Roche, Sanofi, and UCB. ER and JSS are employees at JSS Medical Research, a contract research organization. A.N. Lau, MD, McMaster University; J.C. Thorne, MD, Southlake Regional Health Centre; M. Movahedi, MD, PhD, Toronto General Hospital Research Institute, University Health Network; E. Rampakakis, PhD, JSS Medical Research; A. Cesta, BSc, Toronto General Hospital Research Institute, University Health Network; X. Li, BSc, Toronto General Hospital Research Institute, University Health Network; S. Couto, MSc, Toronto General Hospital Research Institute, University Health Network; J. Sampalis, PhD, JSS Medical Research, and McGill University; C. Bombardier, MD, Toronto General Hospital Research Institute, University Health Network, and University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation, and Mount Sinai Hospital, Division of Rheumatology. Address correspondence to Dr. A.N. Lau, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: arthur.lau@medportal.ca. Accepted for publication October 30, 2018.

From McMaster University, Hamilton, Ontario; Southlake Regional Health Centre, Newmarket, Ontario; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario; JSS Medical Research; McGill University, Montreal, Quebec; University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation; Mount Sinai Hospital, Division of Rheumatology, Toronto, Ontario, Canada. OBRI was funded by peer-reviewed grants from Canadian Institute for Health Research (CIHR), Ontario Ministry of Health and Long-Term Care (MOHLTC), Canadian Arthritis Network (CAN), and unrestricted grants from AbbVie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, and UCB. MM, AC, XL, SC, and CB are employees at OBRI, which was funded by peer-reviewed grants from CIHR, MOHLTC, CAN, and unrestricted grants from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Hospital Janssen, Pfizer, Roche, Sanofi, and UCB. ER and JSS are employees at JSS Medical Research, a contract research organization. A.N. Lau, MD, McMaster University; J.C. Thorne, MD, Southlake Regional Health Centre; M. Movahedi, MD, PhD, Toronto General Hospital Research Institute, University Health Network; E. Rampakakis, PhD, JSS Medical Research; A. Cesta, BSc, Toronto General Hospital Research Institute, University Health Network; X. Li, BSc, Toronto General Hospital Research Institute, University Health Network; S. Couto, MSc, Toronto General Hospital Research Institute, University Health Network; J. Sampalis, PhD, JSS Medical Research, and McGill University; C. Bombardier, MD, Toronto General Hospital Research Institute, University Health Network, and University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation, and Mount Sinai Hospital, Division of Rheumatology. Address correspondence to Dr. A.N. Lau, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: arthur.lau@medportal.ca. Accepted for publication October 30, 2018.

From McMaster University, Hamilton, Ontario; Southlake Regional Health Centre, Newmarket, Ontario; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario; JSS Medical Research; McGill University, Montreal, Quebec; University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation; Mount Sinai Hospital, Division of Rheumatology, Toronto, Ontario, Canada. OBRI was funded by peer-reviewed grants from Canadian Institute for Health Research (CIHR), Ontario Ministry of Health and Long-Term Care (MOHLTC), Canadian Arthritis Network (CAN), and unrestricted grants from AbbVie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, and UCB. MM, AC, XL, SC, and CB are employees at OBRI, which was funded by peer-reviewed grants from CIHR, MOHLTC, CAN, and unrestricted grants from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Hospital Janssen, Pfizer, Roche, Sanofi, and UCB. ER and JSS are employees at JSS Medical Research, a contract research organization. A.N. Lau, MD, McMaster University; J.C. Thorne, MD, Southlake Regional Health Centre; M. Movahedi, MD, PhD, Toronto General Hospital Research Institute, University Health Network; E. Rampakakis, PhD, JSS Medical Research; A. Cesta, BSc, Toronto General Hospital Research Institute, University Health Network; X. Li, BSc, Toronto General Hospital Research Institute, University Health Network; S. Couto, MSc, Toronto General Hospital Research Institute, University Health Network; J. Sampalis, PhD, JSS Medical Research, and McGill University; C. Bombardier, MD, Toronto General Hospital Research Institute, University Health Network, and University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation, and Mount Sinai Hospital, Division of Rheumatology. Address correspondence to Dr. A.N. Lau, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: arthur.lau@medportal.ca. Accepted for publication October 30, 2018.

From McMaster University, Hamilton, Ontario; Southlake Regional Health Centre, Newmarket, Ontario; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario; JSS Medical Research; McGill University, Montreal, Quebec; University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation; Mount Sinai Hospital, Division of Rheumatology, Toronto, Ontario, Canada. OBRI was funded by peer-reviewed grants from Canadian Institute for Health Research (CIHR), Ontario Ministry of Health and Long-Term Care (MOHLTC), Canadian Arthritis Network (CAN), and unrestricted grants from AbbVie, Amgen, Celgene, Hospira, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi, and UCB. MM, AC, XL, SC, and CB are employees at OBRI, which was funded by peer-reviewed grants from CIHR, MOHLTC, CAN, and unrestricted grants from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Hospital Janssen, Pfizer, Roche, Sanofi, and UCB. ER and JSS are employees at JSS Medical Research, a contract research organization. A.N. Lau, MD, McMaster University; J.C. Thorne, MD, Southlake Regional Health Centre; M. Movahedi, MD, PhD, Toronto General Hospital Research Institute, University Health Network; E. Rampakakis, PhD, JSS Medical Research; A. Cesta, BSc, Toronto General Hospital Research Institute, University Health Network; X. Li, BSc, Toronto General Hospital Research Institute, University Health Network; S. Couto, MSc, Toronto General Hospital Research Institute, University Health Network; J. Sampalis, PhD, JSS Medical Research, and McGill University; C. Bombardier, MD, Toronto General Hospital Research Institute, University Health Network, and University of Toronto, Department of Medicine and Institute of Health Policy, Management, and Evaluation, and Mount Sinai Hospital, Division of Rheumatology. Address correspondence to Dr. A.N. Lau, 501-25 Charlton Ave. East, Hamilton, Ontario L8N 1Y2, Canada. E-mail: arthur.lau@medportal.ca. Accepted for publication October 30, 2018.