WASHINGTON, DC – For patients with rheumatoid arthritis (RA) with interstitial lung disease (ILD), long-term survival seems better for those who receive rituximab as their first biologic rather than a tumor necrosis factor-α inhibitor (TNFi), according to a study presented at the annual meeting of the American College of Rheumatology.
Katie Druce, PhD, from the Arthritis UK Centre for Epidemiology at the University of Manchester, and colleagues examined five-year mortality in patients with RA-ILD starting either rituximab or TNFi as their first biologic therapy for RA.
The researchers found that there were 76 deaths in 804.9 person-years in the TNFi cohort and eight deaths in 156.7 person-years in the rituximab cohort during five years of follow-up. Per 1,000 person-years, the deaths rates were 94.4 and 51.0 in the TNFi and rituximab cohorts, respectively. In 36.5 percent of the 74 available death certificates from the TNFi cohort and all three certificates in the rituximab cohort, ILD was recorded.
In the rituximab treated patients, the unadjusted mortality risk was numerically half that seen in the TNFi-treated patients, although the difference was not statistically significant (hazard ratio, 0.51; 95 percent confidence interval, 0.25 to 1.06).
“The main message is that the death rates among patients with RA-ILD who started rituximab as their first biologic were lower compared to patients who started a TNFi,” a coauthor said in a statement.
One author disclosed financial ties to AbbVie and Pfizer.
Druce K, Iqbal K, Watson K, Symmons DPM, Hyrich KL, Kelly C. Mortality in patients with rheumatoid arthritis and interstitial lung disease treated with first line TNFi or rituximab therapies. Presented at: the 2016 American College of Rheumatology/ Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting. November 11-16, 2016; Washington, DC. Abstract #3065