Adherence to etanercept therapy in rheumatoid arthritis patients during 3 years of follow-up

Abstract

ObjectivesTo determine the percentage non-adherence to etanercept in patients with rheumatoid arthritis during three years of follow-up.MethodsDuring study visits in this prospective cohort study, blood samples were taken to determine serum etanercept concentrations using ELISA and patients were asked if they had missed an etanercept dose, at which date and for what reason. Non-adherence was defined as serum etanercept concentration <0.1 μg/mL and no valid reason to miss the prescribed etanercept dose.ResultsIn total, 292 consecutive patients treated with etanercept were included. Most patients had a valid reason to miss their etanercept dose (25/37). In total 12 out of 292 patients (4.1%, 95% confidence interval 2.2–7.2) were non-adherent during the 3 year period. In a small percentage of patients (3.4%, 95% confidence interval 0.8–10.4) who failed to respond to etanercept therapy, according to their rheumatologist, this was associated with inadequate exposure to etanercept and thus non-adherence.ConclusionIn this study, adherence to etanercept therapy was measured using serum etanercept concentration. In most patients an absent etanercept concentration was due to a medical reason. Furthermore, the majority of patients were adherent to etanercept therapy and had adequate drug exposure. In total, only 12 out of 292 patients (4.1%) were non-adherent during 3 years of follow-up. These findings highlight that only a small minority of patients are non-adherent to etanercept treatment, especially compared to adherence rates of other drugs. However, physicians should be aware that in patients failing to respond to treatment, non-adherence is a possible cause.

Evodiamine attenuates adjuvant-induced arthritis in rats by inhibiting synovial inflammation and restoring the Th17/Treg balance

“…Moreover, the function of IL‐1β is to induce matrix‐degrading enzyme production by chondrocytes, and the functions of IL‐6 are to activate leucocytes and osteoclasts, and to regulate the acute phase response in subjects with RA. Biological agents that target these cytokines have been used in clinical practice to treat RA, including etanercept, anakinra (recombinant form of human IL‐1RA) and tocilizumab (directed against the IL6 receptor) . To disclose whether the inhibitory effects on paw swelling were associated with its anti‐inflammatory action or not, we further study effect of Evo on the production of pro‐inflammatory cytokines and inflammatory cell infiltration in the joint tissues.…”

Prediction of infection risk in rheumatoid arthritis patients treated with biologics: are we any closer to risk stratification?

“…Thus far, there have been no implementable biomarkers that can either predict or help modify risk of serious infection. One possible pharmacological biomarker is biologic drug levels that have been previously shown to be associated with long-term treatment response and adherence to biologic treatments [43–45]. Recent emerging evidence from the United Kingdom suggests biologic drug levels could be associated with infection risk over 12 months [46].…”

Effectiveness of electronic drug monitoring feedback to increase adherence in patients with RA initiating a biological DMARD: a randomised clinical trial

“… 16 Furthermore, our high adherence rates correspond with other studies, since we have also corrected for periods of infections and other legitimate reasons for temporarily discontinuation. 3 18 …”

“…1 In rheumatoid arthritis (RA), it is estimated that 4%-37% of the patients are non-adherent to medication, depending on the duration of disease and/or study, method of measurement and medication. [2][3][4][5][6][7][8] Nonadherence is associated with disease flares, radiological damage and increased disability and increased costs. 9 10 Therefore, increasing medication adherence is essential for both patients and society.…”