Retention rates of adalimumab, etanercept and infliximab as first‐line biotherapy agent for rheumatoid arthritis patients in daily practice ‐ Auvergne experience
Autor: | Marion Couderc, Anne Tournadre, Thomas Frayssac, Jean-Jacques Dubost, Martin Soubrier, Zuzana Tatar, Bruno Pereira, A. Fan, Sandrine Malochet-Guinamand, Sylvain Mathieu |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors Gastroenterology Etanercept Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Rheumatology Internal medicine medicine Adalimumab Humans Treatment Failure 030212 general & internal medicine Aged Retrospective Studies 030203 arthritis & rheumatology Biological Products medicine.diagnostic_test Drug Substitution Tumor Necrosis Factor-alpha business.industry Hazard ratio Retrospective cohort study Middle Aged medicine.disease Infliximab Discontinuation Surgery Antirheumatic Agents Rheumatoid arthritis Erythrocyte sedimentation rate Female France business medicine.drug |
Zdroj: | International Journal of Rheumatic Diseases. 21:1924-1932 |
ISSN: | 1756-185X 1756-1841 |
Popis: | Objective To compare, in real-life conditions, the retention rates of anti-tumor necrosis factor (anti-TNF) treatment (etanercept [ETN], adalimumab [ADA] and infliximab [IFX]) initiated as first-line biotherapy for rheumatoid arthritis (RA) and to evaluate, in case of failure, the switch to another anti-TNF or a non-anti-TNF biological. Methods Monocentric retrospective cohort including all patients with RA starting a first anti-TNF between 2001 and 2015. Results Among the 346 patients analyzed, 201 received ETN, 82 ADA and 63 IFX. The first anti-TNF was interrupted in 151 cases. The retention rates were 82.8%, 67.6%, 46.5%, 28.1% and 22.5% at 1, 2, 5, 10 and 15 years, respectively, with a median retention duration of 52.8 (18.9–136.2) months (ETN: 59.3 [19.1–NA), ADA: 79.9 [19.3–136.2] and IFX: 37.2 [17.5–134.5], P = 0.49). The predictive factors of discontinuation were active RA (Disease Activity Score of 28 joints – C-reactive protein [DAS28-CRP] hazards ratio [HR]: 1.22 [1.03–1.45]), inflammatory syndrome (erythrocyte sedimentation rate HR: 1.01 [1.0–1.02]; CRP HR: 1.00 [1.00–1.01]), absence of methotrexate treatment (HR: 0.60 [0.43–0.83]), and corticosteroid use (HR: 1.91 [1.31–2.78]). The patients who switched to another anti-TNF treatment had an inferior retention than those who switched to a non-anti-TNF treatment (HR: 0.39 [0.17–0.87], P = 0.02). Conclusion In real life, there was no difference in retention among the three anti-TNF agents, and 25% of patients continued them at 15 years. After failure of an anti-TNF, the switch to a non-anti-TNF biotherapy showed better retention. |
Databáze: | OpenAIRE |
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