GHP April 2016

ghp April 2016 | 45 Research & Development SIMPONI ® (golimumab) shows higher treatment persistence rates in patients with immune -mediated rheumatic diseases compared with other subcutaneous TNF-alpha inhibitors in Sweden Higher persistence in these patients may be associated with lower healthcare costs A total of 4,903 patients with ankylosing spondylitis, psoriatic arthritis or rheumatoid arthritis (collectively referred to as IMRD) were included in the study.1 The study results show that SC-TNFi-naïve IMRD pa- tients initiating treatment with golimumab in Sweden had significantly higher persistence rates than patients initiating treatment with adalimumab or etanercept at 3 years (unadjusted Kaplan-Meier survival probability estimates, 40% versus 33% and 33% [p=0.042 and p=0.006], respectively).1 The study also indicated that treatment persistence with SC-TNFi may be associated with lower health care resource utilisation (HCRU) costs (~873 Euros [987 US Dollars], p < 0.001), comprising specialised outpatient care, inpatient care and non-disease-modi- fying antirheumatic drug (DMARD) medications.1 “This real-world study demonstrated that, in SC-TNFi- naïve IMRD patients, Simponi had significantly higher persistence rates compared with Humira and Enbrel. These results support existing long-term Simponi data for persistence,” comments Sumesh Kachroo, Director of Outcomes Research at MSD and Swedish registry publication author. As persistence rates observed across all treatments in this study were lower than those observed in clinical trials,1 the study authors suggest the need for all-party (provider-patient-payer-drug manufacturer) engage- ment and development of programmes to increase persistence rates in clinical practice, to improve clinical outcomes.1 Higher persistence rates with golimumab Persistence was measured in accordance with the International Society of Pharmacoeconomics and Out- comes Research (ISPOR) Medication Compliance and Persistence Work Group definition2, from the date of the first filled prescription of an SC-TNFi until the end of the duration of the last prescription.1 Patients were identified through filled prescriptions for adalimumab (n=1,823), etanercept (n=1,704), certolizumab pegol (n=622), and golimumab (n=754) between May 2010 and December 2012, from the Swedish Prescribed Drug Register.1 While persistence was similar for the four agents in the first 12 months’ post-treatment initiation, golimumab consistently demonstrated significantly higher persis- tence than adalimumab and etanercept between 12 and 36 months.1 Golimumab showed numerically higher persistence than certolizumab pegol from 12 to 36 months, how- ever, the difference was not statistically significant at the 5% level over the full study period (p = 0.075).1 Persistence estimates were derived using nonpara- metric survival analysis, Kaplan–Meier (“survival”) functions3, and were estimated with treatment dis- continuation as the failure event. Unadjusted analyses were carried out on the full study population. Analyses of persistence were also carried out on propensity MSD, (Merck & Co., Inc., Kenilworth, NJ, USA in the United States and Canada), announced in February this year the publi- cation of the results of a retrospective analysis of a large Swedish prescription registry study, which described real-world treatment persistence in patients with immune-mediated rheumatic dis- ease (IMRD) newly treated with different subcutaneous tumor necrosis factor-alpha inhibitors (SC-TNFi).1