title: Switching profiles in a population-based cohort of rheumatoid arthritis receiving biologic therapy: results from the KOBIO registry.
abstract: Despite improved quality of care for rheumatoid arthritis (RA) patients, many still experience treatment failure with a biologic agent and eventually switch to another biologic agent. We investigated patterns of biologic treatment and reasons for switching biologics in patients with RA. Patients with RA who had started on a biologic agent or had switched to another biologic agent were identified from the prospective observational Korean nationwide Biologics (KOBIO) registry. The KOBIO registry contained 1184 patients with RA at the time of initiation or switching of biologic agents. Patients were categorized according to the chronological order of the introduction of biologic agents, and reasons for switching biologics were also evaluated. Of the 1184 patients with RA, 801 started with their first biologic agent, 228 were first-time switchers, and 89 were second-time or more switchers. Second-time or more switchers had lower rheumatoid factor and anti-CCP positivity, and higher disease activity scores at the time of enrollment than the other groups. Among these patients, tocilizumab was the most commonly prescribed biologic agent, followed by adalimumab and etanercept. The most common reason for switching biologics was inefficacy, followed by adverse events, including infusion reactions, infections, and skin eruptions. Furthermore, the proportion of inefficacy, as a reason for switching, was significantly higher with respect to switching between biologics with different mechanisms of action than between biologics with similar mechanisms. In this registry, we showed diverse prescribing patterns and differing baseline profiles based on the chronological order of biologic agents.
authors.affiliation: Department of Rheumatology, Chonnam National University Hospital & Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea.
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Park
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea.
authors.forename: Sung Jae
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
authors.forename: Kichul
authors.initials: K
authors.lastname: Shin
authors.affiliation: Department of Rheumatology, Ajou University Hospital, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: Hyoun-Ah
authors.initials: HA
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Yonsei University, Seoul, South Korea.
authors.forename: Yong-Beom
authors.initials: YB
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea.
authors.forename: Seong Wook
authors.initials: SW
authors.lastname: Kang
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Seung-Ki
authors.initials: SK
authors.lastname: Kwok
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea.
authors.forename: Seong-Kyu
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea.
authors.forename: Eon Jeong
authors.initials: EJ
authors.lastname: Nam
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea.
authors.forename: Yoon-Kyoung
authors.initials: YK
authors.lastname: Sung
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Jaejoon
authors.initials: J
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, South Korea.
authors.forename: Chang Hoon
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, South Korea.
authors.forename: Chan Hong
authors.initials: CH
authors.lastname: Jeon
authors.affiliation: Department of Rheumatology, Chonnam National University Hospital & Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea. shinseok@chonnam.ac.kr.
authors.forename: Shin-Seok
authors.initials: SS
authors.lastname: Lee
mesh_terms: D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use*; D001691:Biological Therapy / Q000379:methods*; D002097:C-Reactive Protein / Q000378:metabolism; D057915:Drug Substitution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D056910:Republic of Korea; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001688:Biological Products; D002097:C-Reactive Protein
keywords: Biologic agents; Registry; Rheumatoid arthritis; Switching