AN EVALUATION OF THE USE OF ANAKINRA BY RHEUMATOID ARTHRITIS PATIENTS PREVIOUSLY TREATED WITH A TNF INHIBITOR

Background: RADIUS 1 is a long-term, prospective, multicenter, observational study designed to systematically collect and document use patterns, effectiveness, and safety of DMARD treatments currently used in the management of rheumatoid arthritis (RA).Objectives: The objective of this analysis was to evaluate the use of anakinra, an IL-1 receptor antagonist, by RA patients enrolled in RADIUS 1 who had previously been treated with a TNF inhibitor.Methods: To be enrolled in RADIUS 1, patients were required to be 18 years of age or older, have a diagnosis of RA by American College of Rheumatology (ACR) criteria, and require treatment with a new DMARD. A preliminary analysis of data available through 27 December 2002 identified patients who received anakinra for the first time (ie, within 1 month of their baseline visit), and, of these patients, the subset who had previously been treated with a TNF inhibitor (etanercept or infliximab).Results: The preliminary analysis identified 358 patients who initiated anakinra treatment. Of these patients, 186 had previously received a TNF inhibitor (72% etanercept, 54% infliximab, and 25% both). Concomitant DMARDs at the time of beginning anakinra included methotrexate (37%), leflunomide (19%), hydroxychloroquine (13%), and sulfasalazine (8%). The mean duration of RA at baseline was 10.7 years, and disease severity was assessed by the physician as mild in 3% of patients, moderate in 48%, and severe in 49%. The mean time on anakinra was 6.5 months. Sixty-one of the 186 patients discontinued anakinra; reasons included lack of efficacy (35 patients), adverse events (13), death (2), and other (11). The percentage of patients remaining on anakinra therapy at 6 months is 70.3%.Conclusion: Based on these preliminary data, it is estimated that approximately 70% of patients who initiate anakinra therapy after having previously received a TNF inhibitor will remain on anakinra therapy at 6 months, implying satisfactory efficacy.Citation: , volume , supplement , year 2003, page Session: Rheumatoid arthritis – Treatment