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OP0030 RANDOMIZED CONTROLLED 24-WEEK TRIAL EVALUATING THE SAFETY AND EFFICACY OF BLINDED TAPERING VERSUS CONTINUATION OF LONG-TERM PREDNISONE (5 MG/D) IN PATIENTS WITH RHEUMATOID ARTHRITIS WHO ACHIEVED LOW DISEASE ACTIVITY OR REMISSION ON TOCILIZUMAB

2019; BMJ; Linguagem: Inglês

10.1136/annrheumdis-2019-eular.2883

1468-2060

Gerd R Burmester, Frank Buttgereit, Corrado Bernasconi, J. M. Alvaro-Gracia, Nidia Castro, Maxime Dougados, Cem Gabay, Mohan V. Jacob, van de Laar, J. Michael Nebesky, Attila Pethoe-Schramm, Carlo Salvarani, Marc Y. Donath, Markus R. John,

Cytokine Signaling Pathways and Interactions

Results: Of the 651 and 327 pts randomized to receive UPA and ADA, 126 (19%) and 77 (24%), were considered NR and switched to ADA and UPA respectively.NR demographics were consistent with the overall randomized population.Of the switched pts, ~90% remained in the study through 6 mo ps.Patients switched to ADA (UPA-NR) achieved 59%/26%/12% improvements in ACR20/50/70 responses, and 35% achieved DAS28(CRP) £3.2 at 6 mos ps (Table ).Patients switched to UPA (ADA-NR) achieved 75%/49%/24% improvements in ACR20/50/ 70, and 54% achieved DAS28(CRP) £3.2 at 6 mo-consistent with data observed in a phase 3 study of UPA in bDMARD-IR RA pts. 4 The proportion (95% CI) of pts with infection and serious infection through 6 mos ps appeared consistent with those observed for ADA and UPA during comparable periods (ADA, switched from UPA: infection: 34.1 [26.43, 42.77], serious infection: 1.6 [0.44, 5.60]; UPA, switched from ADA: infection: 40.3 [30.02, 51.42], serious infection: 3.9 [1.33, 10.84] Conclusion: Data from this blinded, controlled study indicate that pts with initial non-response to either UPA or ADA can benefit from switching to the other therapy.No additional safety concerns were observed.These are the first data to demonstrate effectiveness of a TNF inhibitor following failure of a JAK inhibitor.