Comparison of drug retention rates and causes of drug discontinuation between anti-tumor necrosis factor agents in rheumatoid arthritis

Autor: Adrian Ciurea, Axel Finckh, Sophie Martin Du Pan, Cem Gabay, Silvia Dehler, Hans-Rudolf Ziswiler
Přispěvatelé: University of Zurich
Jazyk: angličtina
Rok vydání: 2009
Předmět:
Male
2745 Rheumatology
Kaplan-Meier Estimate
Receptors
Tumor Necrosis Factor
Etanercept
Arthritis
Rheumatoid
Cohort Studies
Drug Hypersensitivity/etiology
Immunology and Allergy
Pharmacology (medical)
Longitudinal Studies
skin and connective tissue diseases
ddc:616
education.field_of_study
Hazard ratio
10051 Rheumatology Clinic and Institute of Physical Medicine
Antibodies
Monoclonal
Middle Aged
Antirheumatic Agents/*administration & dosage/adverse effects
Arthritis
Rheumatoid/*drug therapy
Antirheumatic Agents
Rheumatoid arthritis
Female
Antibodies
Monoclonal/*administration & dosage/adverse effects
medicine.drug
Adult
musculoskeletal diseases
medicine.medical_specialty
Tumor Necrosis Factor-alpha/*antagonists & inhibitors
Population
Immunology
610 Medicine & health
Immunoglobulin G/*administration & dosage/adverse effects
Antibodies
Monoclonal
Humanized
Drug Hypersensitivity
Rheumatology
Internal medicine
medicine
Adalimumab
Humans
education
Adverse effect
Aged
Tumor Necrosis Factor-alpha
business.industry
10060 Epidemiology
Biostatistics and Prevention Institute (EBPI)
medicine.disease
Infliximab
Surgery
Discontinuation
Receptors
Tumor Necrosis Factor/*administration & dosage
Immunoglobulin G
business
Zdroj: Arthritis and Rheumatism, Vol. 61, No 5 (2009) pp. 560-568
ISSN: 0004-3591
Popis: OBJECTIVE: Tumor necrosis factor (TNF) inhibitors have revolutionized the treatment of severe rheumatoid arthritis (RA), yet drug discontinuation is common. The aim of this study was to compare treatment retention rates and specific causes of anti-TNF discontinuation in a population-based RA cohort. METHODS: All patients treated with etanercept, infliximab, or adalimumab within the Swiss Clinical Quality Management RA cohort between 1997 and 2006 were included in the study. Causes of treatment discontinuation were broadly categorized as adverse events (AEs) or nontoxic causes, and further subdivided into specific categories. Specific causes of treatment interruption were analyzed using a Cox proportional hazards model and adjusted for potential confounders. RESULTS: A total of 2,364 anti-TNF treatment courses met the inclusion criteria. Treatment discontinuation was reported 803 times: 309 with etanercept, 249 with infliximab, and 245 with adalimumab. Drug inefficacy represented the largest single cause of treatment discontinuation (55.8% of cases). The median time of receiving anti-TNF therapy was 37 months, but discontinuation rates differed between the 3 anti-TNF agents (P < 0.001), with shorter retention rates for infliximab (hazard ratio [HR] 1.24, 99% confidence interval [99% CI] 1.01-1.51). The specific causes of treatment discontinuation revealed an increased risk of AEs with infliximab (HR 1.4, 99% CI 1.003-1.96), mostly due to an increased risk of infusion or allergic reactions (HR 2.11, 99% CI 1.23-3.62). Other discontinuation causes were equally distributed between the anti-TNF agents. CONCLUSION: In this population, infliximab was associated with higher overall discontinuation rates compared with etanercept and adalimumab, which is mainly due to an increased risk of infusion or allergic reactions.
Databáze: OpenAIRE
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