Structural remission rate and factors associated with radiographic progression in patients with rheumatoid arthritis treated with sarilumab in clinical practice.

INTRODUCTION

Clinical trials have demonstrated the efficacy of sarilumab in preventing radiographic progression. This study investigated the structural remission rate and factors associated with radiographic progression in patients with rheumatoid arthritis (RA) treated with sarilumab in clinical practice.

METHODS

Of 114 patients treated with sarilumab across four centers, 59 with radiographic assessments at baseline and Week 52 were included. Radiographic progression was assessed using the van der Heijde-modified Total Sharp score (mTSS). Patients were divided into methotrexate (MTX) + and MTX - groups; the structural remission rate (ΔmTSS ≤ 0.5) and associated factors were analyzed.

RESULTS

The median age was 69.0 years, median disease duration 10.0 years, mean disease activity score 28-erythrocyte sedimentation rate 4.94, and median modified Health Assessment Questionnaire 0.5, with no differences between groups. Baseline median erosion score was 21.0, joint space narrowing score was 22.0, and mTSS was 37.0. At Week 52, the mean changes were: erosion 0.33, joint space narrowing score 0.18, and mTSS 0.51, with a structural remission rate of 78.0%, 82.4% for the MTX + group, and 76.2% for the MTX - group. The mean change in joint space narrowing score was higher in the MTX - group (0.42) than in the MTX + group (- 0.20) (p = 0.038). Baseline glucocorticoid (GC) use was associated with radiographic progression (odds ratio, 13.1; 95% confidence interval, 2.51-68.9; p = 0.002).

CONCLUSIONS

Sarilumab was associated with limited radiographic progression in patients with RA in clinical practice. Associations with MTX use and baseline GC exposure should be interpreted cautiously given the observational design. Key Points • This study reports the structural remission rate and factors associated with radiographic progression in patients with rheumatoid arthritis treated with sarilumab in clinical practice. • The structural remission rate for sarilumab was 78.0%. The change in the joint space narrowing score was significantly higher in the MTX- group (0.42 ± 1.34) compared with the MTX + group (- 0.20 ± 1.22). • Glucocorticoid use was associated with radiographic progression at 52 weeks (odds ratio, 13.1).