Golimumab in real-life settings: 2 years drug survival and predictors of clinical outcomes in rheumatoid arthritis, spondyloarthritis, and psoriatic arthritis

Abstract Objectives To assess the drug survival of golimumab, and predictors thereof, in patients affected with Rheumatoid arthritis (RA), Spondyloarthritis (SpA), and Psoriatic arthritis (PsA) in a prospective observational cohort. Methods This is a non-interventional, longitudinal study on RA, SpA, and PsA patients starting treatment with golimumab. Endpoints were the 2-years persistence rate of golimumab and predictors of therapy discontinuation. Drug retention was analysed using Kaplan–Meier and Cox models. Hazard ratios (HR) of golimumab discontinuation were estimated by Cox-regression hazard models. Results Of 416 patients starting golimumab, 171 biologic-naïve and 245 inadequate responders to prior biologic drugs, 88 had RA, 147 SpA, and 181 PsA. Global 2-years drug retention was 70.2%, with no different hazard of discontinuation among diseases or line of biologic treatment. The strongest predictor of golimumab discontinuation was gender female (HR 1.95). Golimumab monotherapy was associated with higher risk drug interruption (HR 1.67). Within SpA, predictors of golimumab discontinuation were female sex (HR 4.19), and absence of extra-articular manifestations (HR 4.60). In PsA, duration of disease was negatively (HR 0.93), while golimumab monotherapy positively (HR 2.21) associated to drug interruption. Interestingly, failing to achieve a good EULAR response at 3 months was the only predictor of golimumab discontinuation for RA patients (HR 3.03). Conclusions This study provided evidence that golimumab has high retention rate in real-life settings. SpA male patients with extra-articular manifestations, PsA patients on co-therapy with DMARDs, and RA patients attaining an early clinical response had the highest probability to continue golimumab over 2 years.