Treatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)
| Autor: | Mustafa Acar, Prabhjot Juneja, Malcolm Handel |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
rheumatoid arthritis
medicine.medical_specialty tumor necrosis factor inhibitors Population Arthritis 02 engineering and technology Etanercept Research and Reviews [Open Access Rheumatology] 03 medical and health sciences Psoriatic arthritis 020210 optoelectronics & photonics 0302 clinical medicine Rheumatology Internal medicine ankylosing spondylitis 0202 electrical engineering electronic engineering information engineering medicine Adalimumab education Original Research 030203 arthritis & rheumatology education.field_of_study business.industry medicine.disease Golimumab Discontinuation arthritis Rheumatoid arthritis psoriatic business medicine.drug treatment persistence |
| Zdroj: | Open Access Rheumatology : Research and Reviews |
| ISSN: | 1179-156X |
| Popis: | Mustafa Acar,1 Prabhjot Juneja,2 Malcolm Handel1 1Janssen-Cilag Pty Ltd, Sydney, NSW, Australia; 2Prospection Pty Ltd., Sydney, NSW, Australia Introduction: To describe the persistence of treatment with subcutaneous tumor necrosis factor inhibitors (TNFi) adalimumab, etanercept, and golimumab in immune-mediated rheumatic disease (rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis) by treatment sequence (first-line treatment, second-line or further lines of treatment). Methods: A retrospective cohort analysis was conducted using the Australian Commonwealth Department of Human Services Pharmaceutical Benefits Scheme 10% sample data from January 1, 2010, to June 30, 2016. Pharmaceutical Benefits Scheme indications were used to identify patient prescriptions for rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. A patient was considered persistent until a 3-month gap period where a prescription was not dispensed. The 3-month gap interval was chosen because only 1% of all discontinuations occurred beyond this 3-month period. Results: Data from 2,612 first-line patients were included. Treatment discontinuation among first-line patients treated with etanercept or adalimumab was not significantly different from those treated with golimumab (HR 1.10, 95% CI 0.95–1.28, P=0.22; HR 1.06, 95% CI 0.93–1.22, P=0.39; respectively). Among the 1,276 patients in the second-line cohort (etanercept=41%, adalimumab=41%, golimumab=18%) discontinuation was significantly higher for patients on etanercept compared with golimumab (HR 1.24, 95% CI 1.03–1.50, P=0.03); but not for adalimumab compared with golimumab (HR 1.11, 95% CI 0.91–1.34, P=0.31). In the third-line setting, treatment persistence with etanercept was longer than golimumab (HR 0.75, 95% CI 0.59–0.96, P=0.02), but there was no difference between golimumab and adalimumab. Similar findings occurred in the propensity score matched population. Conclusion: Our study shows there is variance in real-world persistence to TNFi in patients with immune-mediated rheumatic disease by line of therapy, with the time on therapy decreasing by line. Australian persistence has been reported at lower overall rates than international evidence. Keywords: tumor necrosis factor inhibitors, arthritis, psoriatic, rheumatoid arthritis, ankylosing spondylitis, treatment persistence |
| Databáze: | OpenAIRE |
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