Research ArticleAccepted Article
Effectiveness of a second biologic after failure of a non-tumor necrosis factor inhibitor as first biologic in rheumatoid arthritis
Katerina Chatzidionysiou, Merete Lund Hetland, Thomas Frisell, Daniela Di Giuseppe, Karin Hellgren, Bente Glintborg, Dan Nordström, Ritva Peltomaa, Kalle Aaltonen, Nina Trokovic, Eirik K. Kristianslund, Tore K. Kvien, Sella A. Provan, Bjorn Gudbjornsson, Gerdur Grondal, Lene Dreyer, Lars Erik Kristensen, Tanja Schjødt Jørgensen, Lennart T.H. Jacobsson and Johan Askling
The Journal of Rheumatology March 2021, jrheum.201467; DOI: https://doi.org/10.3899/jrheum.201467
Katerina Chatzidionysiou
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Merete Lund Hetland
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Thomas Frisell
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Daniela Di Giuseppe
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Karin Hellgren
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Bente Glintborg
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Dan Nordström
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Ritva Peltomaa
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Kalle Aaltonen
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Nina Trokovic
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Eirik K. Kristianslund
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Tore K. Kvien
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Sella A. Provan
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Bjorn Gudbjornsson
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Gerdur Grondal
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Lene Dreyer
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Lars Erik Kristensen
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Tanja Schjødt Jørgensen
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Lennart T.H. Jacobsson
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Johan Askling
Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; On behalf of the DANBIO Registry, Copenhagen Denmark; Helsinki University and Hospital (ROB-FIN), Departments of Medicine and Rheumatology, Helsinki, Finland; Pharmaceuticals Pricing Board, Ministry of Social Affairs and Health, Helsinki, Finland. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Centre for Rheumatology Research, University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Rheumatology and Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland; Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen F, Denmark; Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Address correspondence to Katerina Chatzidionysiou, MD, PhD. aikaterini.chatzidionysiou@ki.se Rheumatology Unit, Karolinska University Hospital, D2:00, 171 76, Solna, Stockholm, Sweden
Abstract
Objective In Rheumatoid Arthritis (RA), evidence regarding the effectiveness of a second biologic Disease Modifying Anti-Rheumatic Drugs (bDMARDs) in patients whose first ever bDMARD was a non-tumor-necrosis-factor-inhibitor (TNFi) bDMARD is limited. The objective of this study was therefore to assess the outcome of the second bDMARD (non-TNFi [rituximab, abatacept or tocilizumab, separately] and TNFi) after failure of a non-TNFi bDMARD as first bDMARD.
Methods We identified RA patients from the five Nordic biologics registers started treatment with a non-TNFi as first ever bDMARD but switched to a second bDMARD. For the second bDMARD, we assessed survival-on-drug (at 6 and 12 months), and primary response (at 6 months).
Results We included 620 patients starting a second bDMARD (ABA 86, RTX 40, TCZ 67 and TNFi 427) following failure of a first non-TNFI bDMARD. At 6 and 12 months after start of their second bDMARD, around 70% and 50%, respectively, remained on treatment, and at 6 months less than one third of patients were still on their second bDMARD and had reached low disease activity or remission according to DAS28. For those patients whose second bMDARD was a TNFI, the corresponding proportion was slightly higher (40%).
Conclusion The survival-on-drug and primary response of a second bDMARD in RA patients switching due to failure of a non-TNFi bDMARD as first bDMARD is modest. Some patients may benefit from TNFi when used after failure of a non-TNFi as first bDMARD.
In this issue
The Journal of Rheumatology
Vol. 49, Issue 7
1 Jul 2022
Accepted manuscript
Effectiveness of a second biologic after failure of a non-tumor necrosis factor inhibitor as first biologic in rheumatoid arthritis
Katerina Chatzidionysiou, Merete Lund Hetland, Thomas Frisell, Daniela Di Giuseppe, Karin Hellgren, Bente Glintborg, Dan Nordström, Ritva Peltomaa, Kalle Aaltonen, Nina Trokovic, Eirik K. Kristianslund, Tore K. Kvien, Sella A. Provan, Bjorn Gudbjornsson, Gerdur Grondal, Lene Dreyer, Lars Erik Kristensen, Tanja Schjødt Jørgensen, Lennart T.H. Jacobsson, Johan Askling
The Journal of Rheumatology Mar 2021, jrheum.201467; DOI: 10.3899/jrheum.201467
Accepted manuscript
Effectiveness of a second biologic after failure of a non-tumor necrosis factor inhibitor as first biologic in rheumatoid arthritis
Katerina Chatzidionysiou, Merete Lund Hetland, Thomas Frisell, Daniela Di Giuseppe, Karin Hellgren, Bente Glintborg, Dan Nordström, Ritva Peltomaa, Kalle Aaltonen, Nina Trokovic, Eirik K. Kristianslund, Tore K. Kvien, Sella A. Provan, Bjorn Gudbjornsson, Gerdur Grondal, Lene Dreyer, Lars Erik Kristensen, Tanja Schjødt Jørgensen, Lennart T.H. Jacobsson, Johan Askling
The Journal of Rheumatology Mar 2021, jrheum.201467; DOI: 10.3899/jrheum.201467
