Dose Adjustment of Methotrexate Administered Concomitantly with Golimumab for Rheumatoid Arthritis in Japanese Real-Worl
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ORIGINAL RESEARCH
Dose Adjustment of Methotrexate Administered Concomitantly with Golimumab for Rheumatoid Arthritis in Japanese Real-World Clinical Settings Fumiko Yamairi
. Toshiro Yano . Takashi Goto . Tomohisa Iwasaki
Received: June 26, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: The combination of methotrexate (MTX) with biological disease-modifying antirheumatic drugs (bDMARDs) is a recommended treatment option for rheumatoid arthritis (RA) patients showing an inadequate response to MTX monotherapy. However, the Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12765611. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40744020-00228-1) contains supplementary material, which is available to authorized users. F. Yamairi (&) Medical Intelligence Department, Ikuyaku, Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Chuo-ku, Tokyo, Japan e-mail: [email protected] T. Yano Medical Intelligence Department, Ikuyaku, Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Chuo-ku, Osaka, Japan T. Goto Data Science Department, Ikuyaku, Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Chuo-ku, Osaka, Japan T. Iwasaki Data Science Department, Ikuyaku, Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Chuo-ku, Tokyo, Japan
adequate dose of MTX, especially in long-term treatment with bDMARDs/MTX combination therapy, remains under-addressed. Since RA patients require long-term treatment, we examined the effects of using golimumab (GLM) in the long run as well as its persistency and associated factors. Methods: We used the Japan Medical Data Center Inc. (JMDC) administrative claims data of 489 patients receiving GLM therapy for calculating the persistency in patients with constant, reduced, or escalated MTX dosing. The factors associated with GLM persistency were assessed using Cox proportional hazard modeling, controlling for the dose adjustment of concomitant MTX, age, sex, RA disease period, and the initial dose of GLM or concomitant MTX during GLM/MTX combination therapy. Results: During GLM/MTX combination therapy, up to 52% of patients were reported to experience dose adjustments of concomitant MTX treatment (i.e., dose reduction and escalation in 34% and 18% of patients, respectively). Persistency was similar in the MTX dosereduction patients and the MTX dose-constant patients. In the Cox proportional hazard model, no significant differences were observed in association with GLM persistency, including with respect to MTX dose adjustment. Conclusions: GLM prescription was continued in 80% or more (1 year) and 50% or more (3 years) of RA patients receiving reduced concomitant MTX dosing, suggesting that MTX
Rheumatol Ther
dose adjustment (including MTX reduction) could be considered in GLM/MTX combination therapy. Keywords: Golimumab; JMDC Methotrexate; Rheumatoid arthritis
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