Table 2.
Demographics and clinical characteristics at start of second bDMARD therapy, among Swedish patients with RA switching from TNFi 2011–2015
| TNFi | Rituximab | Mean difference versus TNFi (95% CI) | Abatacept | Mean difference versus TNFi (95% CI) | Tocilizumab | Mean difference versus TNFi (95% CI) | |
| Patients, n | 1846 | 376 | 292 | 315 | |||
| Demographics | |||||||
| Age, mean (SD) | 55.1 (14.4) | 60.3 (12.3) | 5.1 (3.6 to 6.5) | 58.7 (13.3) | 3.7 (2.0 to 5.4) | 56.6 (13.8) | 1.6 (−0.0 to 3.2) |
| Female, n(%) | 1408 (76.3) | 270 (71.8) | −2.6 (−7.6 to 2.5) | 233 (79.8) | 5.0 (−0.0 to 9.9) | 241 (76.5) | 1.0 (−3.8 to 5.8) |
| Highest education, n (%) | |||||||
| 9 years or less | 318 (21.7) | 82 (26.5) | 1.2 (−4.0 to 6.3) | 57 (26.1) | 2.3 (−4.1 to 8.1) | 70 (27.5) | 4.1 (−1.8 to 10.0) |
| 10 to 12 years | 705 (48.1) | 156 (50.3) | 2.9 (−3.5 to 8.9) | 111 (50.9) | 4.1 (−3.1 to 11.3) | 110 (43.1) | −4.1 (−10.6 to 2.3) |
| >12 years | 443 (30.2) | 72 (23.2) | −4.1 (−9.2 to 1.2) | 50 (22.9) | −6.4 (−12.0 to −0.4) | 75 (29.4) | 0.1 (−6.0 to 6.2) |
| Country of birth, n (%) | |||||||
| Sweden | 145 (7.9) | 28 (7.4) | −1.8 (−5.6 to 2.0) | 31 (10.6) | −4.0 (−8.7 to 0.6) | 35 (11.1) | −2.3 (−6.5 to 2.1) |
| Scandinavia | 90 (4.9) | 24 (6.4) | 0.5 (−2.2 to 3.2) | 15 (5.1) | 0.2 (−2.5 to 2.8) | 11 (3.5) | −1.2 (−3.6 to 1.1) |
| Other | 1611 (87.3) | 324 (86.2) | 1.3 (−1.8 to 4.1) | 246 (84.2) | 3.8 (0.1 to 7.4) | 269 (85.4) | 3.5 (−0.5 to 7.1) |
| Medical history | |||||||
| Days hospitalised last 5 years, mean (SD) | 6.9 (14.7) | 11.0 (20.7) | 3.1 (0.7 to 5.3) | 8.8 (18.3) | 1.5 (−0.8 to 3.5) | 9.9 (19.4) | 2.3 (0.0 to 4.4) |
| Days of work loss last 5 years, mean (SD) | 478.6 (623.9) | 615.1 (723.0) | 183.0 (103.1 to 264.7) | 564.2 (661.3) | 20.4 (−76.8 to 118.1) | 486.0 (667.6) | −46.3 (−144.5 to 43.7) |
| Healthcare costs last 5 years, TSEK, mean (SD) | 319.2 (256.8) | 370.6 (283.4) | 30.8 (−1.6 to 61.3) | 354.8 (269.0) | 11.3 (−20.6 to 42.9) | 339.1 (274.5) | 12.0 (−20.7 to 43.8) |
| RA-related characteristics | |||||||
| Rheumatoid factor positive, n (%) | 1333 (75.1) | 334 (90.8) | 14.2 (10.7 to 17.9) | 221 (77.0) | 0.6 (−4.8 to 6.1) | 237 (78.0) | 1.9 (−3.3 to 7.2) |
| Disease duration, years, mean (SD) | 12.0 (10.6) | 13.9 (11.4) | 0.5 (−0.8 to 1.7) | 12.8 (11.4) | −0.3 (−1.6 to 1.0) | 10.8 (10.8) | −1.7 (−3.0 to −0.5) |
| HAQ, mean (SD) | 1.05 (0.63) | 1.20 (0.63) | 0.11 (0.03 to 0.18) | 1.21 (0.67) | 0.12 (0.03 to 0.22) | 1.17 (0.64) | 0.09 (0.01 to 0.18) |
| DAS28, mean (SD) | 4.37 (1.37) | 4.88 (1.22) | 0.44 (0.28 to 0.61) | 4.82 (1.30) | 0.38 (0.19 to 0.57) | 5.03 (1.38) | 0.64 (0.45 to 0.82) |
| Tender joints, 0–28, mean (SD) | 5.6 (5.2) | 6.3 (5.5) | 0.8 (0.1 to 1.4) | 6.5 (5.4) | 0.7 (−0.0 to 1.5) | 7.5 (6.7) | 1.8 (1.0 to 2.6) |
| Swollen joints, 0–28, mean (SD) | 4.7 (4.5) | 5.6 (4.9) | 0.9 (0.3 to 1.5) | 5.1 (4.1) | 0.3 (−0.3 to 0.8) | 6.2 (5.3) | 1.5 (0.8 to 2.1) |
| Global health, mean (SD) | 53.6 (24.9) | 56.7 (24.4) | 2.9 (−0.2 to 5.9) | 58.9 (24.2) | 4.9 (1.5 to 8.4) | 59.2 (25.1) | 5.0 (1.6 to 8.3) |
| ESR, mean (SD) | 24.5 (21.4) | 33.8 (25.1) | 7.2 (4.1 to 10.2) | 29.9 (22.3) | 4.0 (0.9 to 6.9) | 33.9 (25.5) | 9.2 (6.0 to 12.4) |
| CRP, mean (SD) | 14.7 (22.1) | 21.4 (25.8) | 5.7 (2.6 to 8.7) | 18.5 (25.0) | 3.5 (−0.0 to 6.8) | 24.5 (29.1) | 9.4 (6.1 to 12.9) |
| VAS pain, mean (SD) | 53.8 (25.4) | 56.1 (25.3) | 2.1 (−1.2 to 5.2) | 59.3 (24.1) | 4.9 (1.5 to 8.3) | 59.8 (25.0) | 5.3 (1.8 to 8.5) |
| Conc. use of MTX, n (%) | 1343 (72.8) | 292 (77.7) | 4.9 (0.4 to 9.6) | 220 (75.3) | 4.1 (−1.2 to 9.8) | 232 (73.7) | 1.2 (−4.1 to 6.5) |
| Conc. use of non-MTX csDMARD, n (%) | 409 (22.2) | 90 (23.9) | 2.0 (−2.9 to 6.3) | 58 (19.9) | −1.8 (−7.0 to 3.3) | 51 (16.2) | −5.5 (−10.1 to −0.8) |
| Conc. use of oral steroids, n (%) | 1106 (59.9) | 252 (67.0) | 7.4 (2.2 to 12.4) | 207 (70.9) | 10.5 (4.7 to 16.5) | 207 (65.7) | 7.0 (1.0 to 12.9) |
| Conc. use of NSAIDs, n (%) | 852 (46.2) | 166 (44.1) | −0.1 (−5.7 to 5.4) | 115 (39.4) | −4.6 (−10.9 to 1.4) | 145 (46.0) | 0.6 (−5.2 to 6.3) |
| Reason for switch, n (%) | |||||||
| Adverse event | 374 (20.6) | 72 (19.5) | −1.5 (−6.0 to 3.0) | 67 (23.8) | 3.1 (−2.3 to 8.3) | 49 (15.8) | −5.8 (−10.6 to −1.4) |
| Lack of effect | 1170 (64.4) | 235 (63.7) | −0.1 (−5.7 to 5.4) | 165 (58.7) | −6.4 (−12.9 to 0.3) | 235 (75.6) | 10.9 (5.4 to 16.3) |
| Other | 272 (15.0) | 62 (16.8) | 1.6 (−2.9 to 5.7) | 49 (17.4) | 3.4 (−1.6 to 8.1) | 27 (8.7) | −5.1 (−8.6 to −1.7) |
Mean differences are compared with TNFi in multivariable linear regression adjusted for age, sex and geographical region with bootstrapped CIs.
bDMARD, biological disease-modifying anti-rheumatic drug; RA, rheumatoid arthritis; TNFi, tumour necrosis factor inhibitor.