Sarika Ogale

Fred Hutchinson Cancer Research Center, Seattle, Washington, United States

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Publications (26)78.28 Total impact


  • No preview · Article · Sep 2015
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    ABSTRACT: Introduction This study examined the use of anti-tumor necrosis factor (anti-TNF) monotherapy, adherence with non-biologic disease-modifying anti-rheumatic drugs (nbDMARDs) in patients receiving a combination of anti-TNF therapies and nbDMARDs, and the impact of nbDMARD adherence on anti-TNF persistence among patients with rheumatoid arthritis (RA). Methods Patients with RA (aged ≥18 years) from a US commercial health plan with claims for anti-TNFs (2006–2010) were defined as either biologic-naive or -exposed anti-TNF initiators based on previous nbDMARD use. Adherence to nbDMARDs and anti-TNF persistence were estimated. Cox regression estimated the association between nbDMARD adherence and anti-TNF persistence. Results Among 9764 patients identified (mean age 50.2 years; 78% female), 55% of biologic-naive patients and 49% of previously exposed patients initiated any combination therapy during follow-up. Among biologic-naive combination therapy patients, 53% adhered to nbDMARD therapy <80% of the time while receiving anti-TNF therapies; 33% had <60% adherence. Compared with the most adherent patients, patients adherent to nbDMARDs 20% to 79% of the time were 30% to 20% more likely to discontinue their anti-TNF therapy in the period >90 days after starting the anti-TNF therapy. This relationship was not observed for patients with nbDMARD adherence of <20% (who were less likely to discontinue their anti-TNF therapy during the first 90 days of treatment). Conclusion Almost one-third of patients with RA receiving anti-TNF therapy received it as pure monotherapy. About one-third of combination therapy recipients had <60% adherence to nbDMARDs. Higher nbDMARD adherence may be associated with better anti-TNF persistence after an initial treatment period.
    Preview · Article · Aug 2015
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    ABSTRACT: Introduction Limited data are available to explain nonadherence to methotrexate (MTX) therapy in patients with rheumatoid arthritis (RA). Better understanding of patterns of MTX use and reasons for nonadherence may help identify patients who would benefit from alternative RA treatments and potentially aid in developing strategies to increase overall adherence. The purpose of this study was to assess patients’ self-reported adherence to MTX and to identify reasons for nonadherence. Methods Patient panel members in the US self-reporting a diagnosis of RA of ≥3 months’ and current MTX use of ≥4 weeks’ duration, with or without concomitant use of another RA prescription medication, participated in this cross-sectional, web-based survey. Results The sample population (251 MTX monotherapy, 250 MTX combination therapy) was predominantly female, white, non-Hispanic, and educated; 48% were 18-44 years-old, 47% had medical comorbidities, 66% were first diagnosed with RA ≤5 years earlier, 51% reported MTX use of Conclusion Nearly half the sample reported poor MTX adherence because they forgot to take it, thought it was not needed when they felt well, or had long-term safety concerns. Patients taking ≥2 other RA prescription medications were less likely to report good adherence. Reducing treatment burden without sacrificing efficacy may be a strategy worth evaluating.
    Preview · Article · May 2015

  • No preview · Article · May 2015 · Value in Health
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    ABSTRACT: Introduction While there is a substantial body of literature on the comparative healthcare costs of biologics used to treat rheumatoid arthritis (RA), nearly all of these investigations have been exclusively focused on anti-tumor necrosis factor-α (anti-TNF) agents in the setting of first-line biologic treatment. This study compared healthcare costs between RA patients treated with infused biologics after previously using at least one other biologic agent. Methods Using a large US administrative claims dataset, adult RA patients initiating an infused biologic (abatacept, infliximab, tocilizumab) between January 1, 2010 and January 1, 2012 (initiation = index) were identified. Rituximab was excluded because of unique dosing intervals, which make it difficult to determine treatment discontinuation using a claims database. Patients were required to have used one or more other biologic (infused or injected) at any time before index. Patients could contribute multiple observations to the dataset; one for each infused biologic they initiated between January 1, 2010 and January 1, 2012. A 6-month period before index was used to measure patient characteristics. A variable-length follow-up period after index was used to measure per-patient per-month (PPPM) healthcare costs, including biologic costs, RA-related healthcare costs, and all-cause healthcare costs. Generalized estimating equations models compared healthcare costs between the biologic agents, adjusting for patients’ demographics and clinical characteristics. Results The sample comprised 3,771 infused biologic initiations (abatacept = 1,759; infliximab = 922; tocilizumab = 1,090); the mean age of participants was 55 years, 82 % were female, and the median follow-up ranged from 251 to 280 days. Compared with other patients, patients treated with tocilizumab had significantly lower (all P Conclusions Among RA patients treated with infused biologics after previously using at least one other biologic, patients treated with tocilizumab had the lowest real-world healthcare costs, largely driven by lower costs directly related to biologic treatment. Such biologic-related cost differences may be driven by variations in real-world treatment patterns (e.g., dose, escalation, treatment frequency).
    Preview · Article · Mar 2015 · Drugs - Real World Outcomes
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    ABSTRACT: To estimate the cost-effectiveness of tocilizumab (TCZ) monotherapy (Mono) versus adalimumab (ADA) Mono from the US payer perspective in patients with rheumatoid arthritis for whom methotrexate is inappropriate. We compared TCZ Mono (8 mg/kg monthly) with ADA Mono (40 mg every other week), using efficacy results from a head-to-head study, ADalimumab ACTemrA (ADACTA). We calculated the incremental cost per responder (achievement of American College of Rheumatology [ACR] 20% improvement criteria, ACR 50% improvement criteria, ACR 70% improvement criteria, or low disease activity score) for TCZ versus ADA at 6 months. A patient-level simulation was used to estimate the lifetime incremental cost per quality-adjusted life-year (QALY) of initiating treatment with TCZ Mono versus ADA Mono. Both drugs are followed by an etanercept-certolizumab-palliative care sequence. Nonresponders discontinue at 6 months; responders experience a constant probability of discontinuation. Discontinuers move to the next treatment. ACR responses produce changes in the Health Assessment Questionnaire (HAQ) score. We mapped the HAQ score to utility to estimate QALYs. Costs include those related to hospitalization and those related to treatment (drug acquisition, administration, and monitoring). Probabilistic and one-way sensitivity analyses were conducted, along with several scenario analyses. Compared with ADA, TCZ was more effective, with an estimated 6-month incremental cost ranging from $6,570 per additional low disease activity score achiever to $14,265 per additional ACR 70% improvement criteria responder. The lifetime incremental cost-effectiveness ratio was $36,944/QALY. TCZ Mono is projected to be cost-effective compared with ADA Mono in patients with severe rheumatoid arthritis for whom methotrexate is not appropriate, from a US payer perspective. Copyright © 2015. Published by Elsevier Inc.
    Full-text · Article · Jan 2015 · Value in Health
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    ABSTRACT: Introduction The aim of this study was to compare the response between subsequent use of anti-tumor necrosis factor α (anti-TNF) agents and biologic disease-modifying anti-rheumatic drugs (bDMARD) with other mechanism of action (MOA) in rheumatoid arthritis (RA) patients with history of anti-TNF treatment as their first bDMARD. Methods A retrospective chart review was conducted at eight community-based rheumatology practices in the United States in 2012. Routine Assessment of Patient Index Data 3 (RAPID3) response was measured by comparing baseline and 6-month scores. Poor response was defined as decrease <1.8 points, follow-up score >12, or treatment discontinuation before 6 months. Percentages of patients with good and good or moderate RAPID3 response were compared for second and third biologics. Multivariate models controlled for potential confounders. Results Of 176 patients whose charts were abstracted, 122 (69.3%) received another anti-TNF agent after they discontinued their first anti-TNF. RAPID3 scores were available for 160 patients. A patient receiving a second bDMARD with another MOA had a higher good or moderate response than a patient receiving anti-TNF (53.5 vs. 30.7%, p = 0.01). In the multivariate models, treatment with another MOA was more likely to produce a good RAPID3 response [odds ratio (OR), 2.42; 95% confidence interval (CI), 1.05–5.58] or a good or moderate response (OR, 2.21; 95% CI, 1.23–3.97) than treatment with an anti-TNF. Conclusion In patients who have discontinued anti-TNF agents as their first bDMARD, RAPID3 response rates are better for those receiving agents with a different MOA rather than another anti-TNF. Physicians should consider using a bDMARD with a different MOA as the next bDMARD for RA patients whose anti-TNF agent has failed.
    Preview · Article · Dec 2014
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    ABSTRACT: Introduction: The objective of this study was to investigate clinical effectiveness and incremental lifetime costs associated with first-line bevacizumab in older patients with metastatic colorectal cancer (mCRC). Methods: Patients diagnosed with mCRC in 2004-2007 were identified from the Surveillance, Epidemiology, and End Results-Medicare database and stratified by first-line treatment (no chemotherapy [CTx], CTx alone, CTx plus bevacizumab). The impact of first-line bevacizumab on survival was investigated using a propensity score adjusted multivariate Cox proportional hazards model. Mean lifetime costs for each cohort were calculated using Medicare claims for all services rendered between diagnosis and end of follow-up, adjusting for death and censoring. Results: A total of 4,414 patients (mean age: 77.3 years) were identified, of whom 15% received first-line bevacizumab. Among first-line-treated patients, bevacizumab receipt was associated with improved overall survival (hazard ratio: 0.85 [95% confidence interval: 0.75-0.97]; p = .013), and this benefit was limited to patients who received >1 month of bevacizumab therapy. Median and mean survival were greatest in patients treated with CTx plus bevacizumab relative to CTx alone (CTx plus bevacizumab median 19.4 months [mean 28.0 months] vs. CTx alone median 15.1 months [mean 22.9 months]; p < .001), as were mean lifetime costs (mean per patient cost $143,284 vs. $111,280). Compared with CTx alone, CTx plus bevacizumab was associated with a 5.1-month increase in mean survival and a $32,004 increase in mean lifetime treatment costs, with an incremental cost of $75,303 per life-year gained. Conclusion: Bevacizumab use is associated with longer survival than CTx alone in older patients treated in real-world clinical settings, at an incremental cost of $75,303 per life-year gained.
    Full-text · Article · Aug 2014 · The Oncologist
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    ABSTRACT: Objective To compare biologics as monotherapy or in combination with methotrexate (MTX) in terms of patient reported outcomes (PROs) in RA patients with an inadequate response to conventional DMARDs (DMARD-IR). Methods With a systematic literature review 17 RCTs were identified that evaluated adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, abatacept, anakinra or tocilizumab. Treatment effects in terms of pain (0-100 mm), patient’s global assessment of disease activity (PGA; 0-100 mm), Health Assessment-Questionnaire (HAQ) disability index (DI; 0–3), and the physical component summary (PCS) of the SF36 Health Survey (0–100) at 24 weeks were combined by means of Bayesian network meta-analyses. Results With tocilizumab monotherapy, greater improvements in pain (difference = -11.1; (95% Credible Interval -21.3, -0.1)) and PGA (-10.3 (-20.4, 0.8)) were observed than with aTNF monotherapy. Tocilizumab was at least as efficacious as aTNF in HAQ-DI improvements (-0.16; (-0.37, 0.05)). aTNF + MTX (-17.9 (-23.1, -13.0) & -19.1 (-24.2, -14.4)), abatacept + MTX (-23.0 (-47.3, 1. 5) & -13.6 (-28.4, 2.0)) and tocilizumab + MTX (-16.0 (-26.3, -6.3) & -15.1 (-25.1, -5.7)) showed comparable reductions in pain and PGA relative to MTX. Efficacy of anakinra + MTX was much smaller as compared to other biologics. The greatest improvements in HAQ-DI relative to MTX were observed with aTNF + MTX (-0.30 (-0.37, -0.22)) and tocilizumab + MTX (-0.27 (-0.42, -0.12)), followed by abatacept + MTX (-0.21 (-0.37, -0.05)) and anakinra + MTX (-0.11 (-0.26, 0.05)). The improvements in SF36-PCS with abatacept + MTX, aTNF + MTX and tocilizumab + MTX were comparable. There is a >90% probability that aTNF + MTX results in a greater improvement in pain (-12.4), PGA (-16.1) and HAQ-DI (-0.21) than aTNF as monotherapy. Efficacy of tocilizumab + MTX showed comparable improvements in PROs as tocilizumab monotherapy. Conclusions Based on a network meta-analysis involving indirect comparison of trial findings, the following observations were made for DMARD-IR patients. In monotherapy, tocilizumab was associated with a greater improvement in pain and self-reported disease activity than aTNF, and was at least as efficacious regarding functional ability. The improvements in PROs with aTNF, abatacept and tocilizumab in combination with MTX were comparable. Improvements in PROs with tocilizumab as monotherapy were similar to that of tocilizumab + MTX, whereas aTNF as monotherapy was likely to be less efficacious than aTNF + MTX.
    Full-text · Article · Jul 2014 · Health and Quality of Life Outcomes
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    Full-text · Article · May 2014 · Value in Health
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    ABSTRACT: Background Biologic agents have revolutionised the treatment of rheumatoid arthritis (RA). Few comparative, long-term data on treatment effectiveness and safety in the real world exist for patients typically seen in clinical practice. Objectives To present the study design and baseline characteristics for 411 patients enrolled in the CORRONA CERTAIN study from 28 Oct 2010 to 30 Sept 2011. Methods The CORRONA registry is a network of over 100 private and academic rheumatology practices across the US. The CORRONA CERTAIN is a comparative effectiveness prospective cohort study of adult patients with RA conducted across CORRONA participating sites. Patients with moderate disease activity (CDAI score >10) initiating a biologic agent (either for the first time or switching from a previous biologic) are eligible to enroll in CERTAIN. Physician and patient assessments, including lab values and biomarkers, are mandated at baseline, 3-, 6-, 9- and 12-month follow-up visits. A total of 2,750 patients will be enrolled over 3 years. The primary endpoint of CERTAIN is CDAI <10, and comparative safety will also be evaluated. Results Enrolled patients are 76.7% female, 84.3% Caucasian; median age is 56 (IQR: 47-64). Age, sex and race distributions are similar in TNF and nTNF cohorts. About 62% of the patients were initiated on a TNF and 38% on nTNF. Disease duration was 3 years (IQR: 1-8) for TNF cohort and 9 years (IQR: 3-16) for nTNF cohort. Biologic initiations included: etanercept (17.0%), adalimumab (16.5%), abatacept (16.3%), tocilizumab (15.8%), certolizumab (12.9%), infliximab (10.5%), rituximab (6.1%) and golimumab (4.9%). Monotherapy was used in 34.6% of TNF patients and 37.6% of nTNF patients. Fifty-four percent of TNF and 8.3% of the nTNF initiators were biologic naive. Among patients previously exposed to a different biologic, reasons for discontinuing the previous biologic were failure to maintain response (35%), minor side effect (12%), inadequate initial response (9%) and serious side effect (3%). For the TNF cohort, median baseline values were 25.0 (IQR: 17.0-34.0) for CDAI, 4.5 (IQR: 3.7-5.4) for DAS28 (CRP) and 5.0 (IQR: 1.7-10.8) for CRP. Corresponding values for the nTNF cohort were 29.0 (IQR: 23.0- 37.0), 5.0 (IQR: 4.3- 5.6) and 4.9 (IQR: 1.6-16.0). At baseline 14.9% of the TNF initiators and 9.7% of the nTNF initiators had total cholesterol >240 mg/dl. Among the patients enrolled, 30.4% had HTN, 8.5% had diabetes, 7.3% had a history of CVD and 5.4% reported a history of cancer. Conclusions The CERTAIN study will generate comparative effectiveness and safety data to improve the quality of care and treatment outcomes for RA patients on biologics. Disclosure of Interest D. Pappas: None Declared, A. John Employee of: Roche/Genentech, J. Greenberg Shareholder of: CORRONA, Consultant for: AstraZeneca, Novartis, Pfizer, CORRONA, J. Devenport Employee of: Roche/Genentech, J. Kremer Shareholder of: CORRONA, Grant/Research support from: Abbott, Amgen, AstraZeneca, BMS, Genentech, Lilly, Pfizer, Consultant for: Amgen, Genentech, Lilly, Pfizer, Employee of: CORRONA, Speakers Bureau: Abbott, Amgen, BMS, Pfizer, S. Ogale Employee of: Roche/Genentech, G. Reed Grant/Research support from: CORRONA, Consultant for: CORRONA, Employee of: University of Massachusetts Medical School, Paid Instructor for: Harvard Medical School, K. Saunders: None Declared, J. Curtis Grant/Research support from: Roche/Genentech, UCB, Centocor, BMS, Abbott, Amgen, CORRONA, Pfizer, Consultant for: Roche/Genentech, UCB, Centocor, BMS, Abbott, Amgen, CORRONA, Pfizer
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
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    ABSTRACT: Background Switching and discontinuation of biologic disease modifying antirheumatic drugs (DMARDs) may occur due to inadequate response to the current biologic, side effects, or other factors. Objectives To compare, between biologic agents, persistence (time-to biologic DMARD switching and time-to switching/discontinuation) among patients with rheumatoid arthritis (RA) who have previously used at least one other biologic agent. Methods Using a large U.S. administrative claims dataset, we conducted a retrospective study of adult RA patients, starting a biologic (abatacept [ABA], adalimumab [ADA], certolizumab [CZP], etanercept [ETA], golimumab [GOL], infliximab [INF], rituximab [RTX], or tocilizumab [TCZ]) between Jan 1, 2010 and Jun 30, 2011. The date of initiation for the biologic used during this period was designated the index, and patients who had used at least one other biologic at any time prior to the index were included. A 6-month pre-index period was used to measure patient characteristics and a variable-length post-index period was used to measure persistence defined in two ways: 1) time-to switch (days from index until switch to a different biologic agent) and 2) time-to switch/discontinuation (days from index until the first occurrence of a 90-day gap in treatment with the initiated biologic agent or a switch to a different biologic agent); for patients who had not switched or discontinued, follow-up was censored at the end of the study period (Jun 30, 2011) or disenrollment from insurance. Patients could contribute multiple observations to the dataset; one for each biologic they initiated sequentially during the study period. Multivariable Cox proportional hazards models with the Huber-White “sandwich” variance estimator were used to compare persistence between the biologic agents, adjusting for patients’ demographics and pre-index health status, comorbidities, and medication use. Rituximab was excluded from analyses of time-to switch/discontinuation because its long retreatment intervals complicate the definition of discontinuation based on gaps in therapy. Results The sample comprised 7,515 observations; mean patient age 54 years, 81% female. During the pre-index period 75% of patients used corticosteroids and 53% used methotrexate. Table displays multivariable-adjusted hazard ratios (HRs), with TCZ as the reference category, for the two persistence definitions. Conclusions Among RA patients initiating biologic agents after previously failing a different biologic, differences in persistence exist between agents. Using time-to switch as a measure of persistence, TCZ had significantly better persistence compared with all studied biologics, except RTX, which was similar; using time-to switch/discontinuation as a measure of persistence, TCZ had significantly better persistence compared with ADA, but similar to the other biologics. Disclosure of Interest S. Johnston Employee of: Truven Health Analytics, D. McMorrow Employee of: Truven Health Analytics, A. Farr Employee of: Truven Health Analytics, P. Juneau Employee of: Truven Health Analytics, S. Ogale Shareholder of: Genentech, Employee of: Genentech
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
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    ABSTRACT: To evaluate whether patients with rheumatoid arthritis who did not respond sufficiently to tocilizumab (TCZ) plus disease-modifying antirheumatic drug (DMARD) treatment by Week 8 responded at later timepoints when continuing to take their original dose of TCZ. In this posthoc analysis of data from phase III randomized controlled trials of inadequate responders (IR) to DMARD or tumor necrosis factor-α inhibitors (anti-TNF), percentages of patients meeting early response criteria were calculated by randomized treatment arm (TCZ 4 mg/kg, 8 mg/kg, or placebo in combination with DMARD). Percentages of patients achieving certain disease activity thresholds at later timepoints were calculated for patients who had/had not achieved response by Week 8. In DMARD-IR early nonresponders, 29.0%, 17.2%, and 3.7% of TCZ 8 mg/kg-randomized, TCZ 4 mg/kg-randomized, and placebo-randomized patients, respectively, achieved 28-joint Disease Activity Score (DAS28) ≤ 3.2 by Week 24. Among anti-TNF-IR patients without early response, 26.5%, 8.5%, and 1.9% of TCZ 8 mg/kg-randomized, TCZ 4 mg/kg-randomized, and placebo-randomized patients, respectively, achieved DAS28 ≤ 3.2 at Week 24. A substantial number of DMARD-IR patients taking TCZ 4 or 8 mg/kg and anti-TNF-IR patients taking TCZ 8 mg/kg who failed to respond by 8 weeks benefited from continued TCZ treatment in combination with DMARD. In contrast, the anti-TNF-IR patients without early responses who continued to take TCZ 4 mg/kg were unlikely to experience a cumulative benefit. ClinicalTrials.gov registration numbers: NCT00106548, NCT00106574, NCT00106535, NCT00106522.
    No preview · Article · Jan 2014 · The Journal of Rheumatology
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    N.M. Engel-nitz · S. Ogale · M. Kulakodlu

    Preview · Article · Nov 2012 · Value in Health
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    Preview · Article · Nov 2012 · Value in Health
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    Preview · Article · Nov 2012 · Value in Health

  • No preview · Article · Aug 2012 · PharmacoEconomics
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    ABSTRACT: Objective. To investigate the effect of tocilizumab on patient-reported outcomes (PROs) in RA patients with inadequate responses to TNF inhibitors (TNFis). Methods. In a Phase III randomized controlled trial, 489 patients received 4 or 8 mg/kg tocilizumab or placebo every 4 weeks plus MTX for 24 weeks. Mean changes from baseline over time and proportions of patients reporting improvements greater than or equal to minimum clinically important differences (MCIDs) in PROs were analyzed. Results. At week 24, 8 mg/kg resulted in significantly greater improvements vs placebo in pain, global assessment of disease activity (P = 0.001), Health Assessment Questionnaire-Disability Index (HAQ-DI; P < 0.0001), Functional Assessment of Chronic Illness Therapy-Fatigue (P = 0.0150) and Medical Outcomes Survey Short Form 36 (SF-36 v2) Physical Component Summary (PCS; P = 0.0003) scores, all greater than MCID; 4 mg/kg resulted in greater improvements in pain (P = 0.0100), HAQ-DI (P = 0.0030) and SF-36 PCS (P = 0.0020) scores. Tocilizumab-associated improvements were evident as early as week 2. At week 24, more tocilizumab-treated than control patients reported improvements greater than or equal to MCID in SF-36 domain scores and related PROs (50.9–84.9% vs 35.0–51.7%) and achieved ACR50 responses and/or Disease Activity Score 28 (DAS28) remission with PRO improvements greater than or equal to MCID (36.2–51.2% vs 10–20.7% and 10.7–37.5% vs 0.0–3.4%, respectively). Conclusion. Tocilizumab treatment in patients with inadequate responses to TNFis resulted in rapid and sustained improvements in multiple PROs that were statistically significant and clinically meaningful, consistent with previous efficacy reports. Trial Registration. ClinicalTrials.gov, http://clinicaltrials.gov/, NCT00106522.
    Full-text · Article · Jun 2012 · Rheumatology (Oxford, England)
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    Full-text · Article · Jun 2012 · Value in Health
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    ABSTRACT: Improvements in health-related quality of life after treatment with tocilizumab in patients with rheumatoid arthritis refractory to tumour necrosis factor inhibitors: results from the 24-week randomized controlled RADIATE study Abstract Objective. To investigate the effect of tocilizumab on patient-reported outcomes (PROs) in RA patients with inadequate responses to TNF inhibitors (TNFis). Methods. In a Phase III randomized controlled trial, 489 patients received 4 or 8 mg/kg tocilizumab or placebo every 4 weeks plus MTX for 24 weeks. Mean changes from baseline over time and proportions of patients reporting improvements greater than or equal to minimum clinically important differences (MCIDs) in PROs were analyzed. Results. At week 24, 8 mg/kg resulted in significantly greater improvements vs placebo in pain, global assessment of disease activity (P = 0.001), Health Assessment Questionnaire-Disability Index (HAQ-DI; P < 0.0001), Functional Assessment of Chronic Illness Therapy-Fatigue (P = 0.0150) and Medical Outcomes Survey Short Form 36 (SF-36 v2) Physical Component Summary (PCS; P = 0.0003) scores, all greater than MCID; 4 mg/kg resulted in greater improvements in pain (P = 0.0100), HAQ-DI (P = 0.0030) and SF-36 PCS (P = 0.0020) scores. Tocilizumab-associated improvements were evident as early as week 2. At week 24, more tocilizumab-treated than control patients reported improvements greater than or equal to MCID in SF-36 domain scores and related PROs (50.9–84.9% vs 35.0–51.7%) and achieved ACR50 responses and/or Disease Activity Score 28 (DAS28) remission with PRO improve-ments greater than or equal to MCID (36.2–51.2% vs 10–20.7% and 10.7–37.5% vs 0.0–3.4%, respectively). Conclusion. Tocilizumab treatment in patients with inadequate responses to TNFis resulted in rapid and sustained improvements in multiple PROs that were statistically significant and clinically meaningful, con-sistent with previous efficacy reports.
    Full-text · Article · Jan 2012 · British journal of rheumatology

Publication Stats

135 Citations
78.28 Total Impact Points

Institutions

  • 2014
    • Fred Hutchinson Cancer Research Center
      • Division of Public Health Sciences
      Seattle, Washington, United States
  • 2012
    • Stanford University
      • Division of Rheumatology
      Palo Alto, California, United States