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

Pan, Sophie Martin Du; Dehler, Silvia; Ciurea, Adrian; Ziswiler, Hans‐Rudolf; Gabay, Cem; Finckh, Axel

doi:10.1002/art.24463

Cited by 183 publications

(94 citation statements)

References 44 publications

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“…Similar persistence with the infliximab, adalimumab and etanercept has previously been demonstrated in some studies [45]–[48], while differences in persistence was observed in others [18], [19], [49]–[55]. Controversial results of previous studies may be due to different population or methodology (e.g.…”

Section: Discussionsupporting

confidence: 62%

Comparative Persistence of the TNF Antagonists in Rheumatoid Arthritis – A Population-Based Cohort Study

et al. 2014

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ObjectiveTo compare persistence with tumor necrosis factor alpha (TNF) antagonists among rheumatoid arthritis patients in British Columbia. Treatment persistence has been suggested as a proxy for real-world therapeutic benefit and harm of treatments for chronic non-curable diseases, including rheumatoid arthritis. We hypothesized that the different pharmacological characteristics of infliximab, adalimumab and etanercept cause statistically and clinically significant differences in persistence.MethodsWe conducted a population-based cohort study using administrative health data from the Canadian province of British Columbia. The study cohort included rheumatoid arthritis patients who initiated the first course of a TNF antagonist between 2001 and 2008. Persistence was measured as the time between first dispensing to discontinuation. Drug discontinuation was defined as a drug-free interval of 180 days or switching to another TNF antagonist, anakinra, rituximab or abatacept. Persistence was estimated and compared using survival analysis.ResultsThe study cohort included 2,923 patients, 63% treated with etanercept. Median persistence in years (95% confidence interval) with infliximab was 3.7 (2.9–4.9), with adalimumab 3.3 (2.6–4.1) and with etanercept 3.8 (3.3–4.3). Similar risk of discontinuation was observed for the three drugs: the hazard ratio (95% confidence interval) was 0.98 (0.85–1.13) comparing infliximab with etanercept, 0.95 (0.78–1.15) comparing infliximab with adalimumab and 1.04 (0.88–1.22) comparing adalimumab with etanercept.ConclusionsSimilar persistence was observed with infliximab, adalimumab and etanercept in rheumatoid arthritis patients during the first 9 years of use. If treatment persistence is a good proxy for the therapeutic benefit and harm of these drugs, then this finding suggests that the three drugs share an overall similar benefit-harm profile in rheumatoid arthritis patients.

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Section: Discussionsupporting

confidence: 62%

Comparative Persistence of the TNF Antagonists in Rheumatoid Arthritis – A Population-Based Cohort Study

et al. 2014

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“…The majority (75 %) of patients were classified as having moderate- or high-disease activity per DAS28 scores. The substantially shorter mean treatment duration of bDMARD therapy (4.7–34.5 weeks) in our study population versus that shown in other studies [23, 24] may be responsible for the suboptimal remission rates that we observed. The mean duration of treatment with etanercept, adalimumab, and infliximab in Italian patients with RA from the Italian Group for the Study of Early Arthritis registry was 3.1, 2.6, and 2.7 years, respectively [23].…”

Section: Discussioncontrasting

confidence: 79%

The usage of biological DMARDs and clinical remission of rheumatoid arthritis in China: a real-world large scale study

Liu

et al. 2016

Clin Rheumatol

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The aims of this study are to characterize the biological disease-modifying antirheumatic drug (bDMARD) usage patterns in real-life and examine the remission rate of rheumatoid arthritis (RA) patients receiving bDMARDs in routine clinical practice in China. Consenting RA patients (≥18 years) from 15 teaching hospitals and receiving marketed bDMARDs were included. In total, 802 patients (81.3 % women, 49.0 ± 13.9 years) were included; 89.5 % were receiving a combination of bDMARDs and conventional synthetic DMARDs (csDMARDS), whereas 10.5 % were receiving bDMARD monotherapy. Etanercept (including Enbrel® and local brand Yi Sai Pu® and Qiangke®), tocilizumab, adalimumab, and infliximab were used by 66.6 %, 17.0 %, 7.5 %, and 6.6 % patients, respectively. Etanercept was used at a mean weekly dose of 38.2 ± 15.6 mg for 25.5 ± 47.0 weeks and tocilizumab at 94.5 ± 21.9 mg for 4.7 ± 7.5 weeks. Overall rate of remission was 12.6 %, 5.4 % , and 3.5 % based on DAS28, CDAI, and SDAI scores, respectively. Compared with patients receiving bDMARDs for <3 months, those receiving bDMARDs for ≥3 months exhibited significantly lower DAS28 scores (p < 0.0001), and a significantly higher proportion of patients who received bDMARDs for ≥12 months achieved the treatment goal (remission or low disease activity, 62.5 % vs. 18.3 %, p < 0.0001). Patients receiving combination therapy with csDMARDs exhibited lower DAS28 scores than patients receiving bDMARD monotherapy (4.3 vs. 4.8, p = 0.011). This large-scale real-world study showed that bDMARD usage patterns in routine clinical practice in China were in accordance with international guidelines for RA management despite the short treatment duration. Longer duration of bDMARD usage and combination therapy showed a favored outcome of RA.

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“…Intermittent therapy or re-exposure after a long treatment-free interval may be associated with an enhanced immune response (or loss of tolerance) to the biological agent, and thus retreated patients must be considered at risk of reactions [5,20,[44][45][46]. Even if some conflicting results have recently been reported [47,48], in our case series, we confirmed a higher incidence of infliximabrelated reactions at the beginning of the second course of therapy [6].…”

Section: Recognition Of Patients At Risksupporting

confidence: 89%

Immediate adverse reactions to biologicals: from pathogenic mechanisms to prophylactic management

Vultaggio

Maggi

Matucci

2011

Current Opinion in Allergy &Amp; Clinical Immunology

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

Cited by 183 publications

References 44 publications

Comparative Persistence of the TNF Antagonists in Rheumatoid Arthritis – A Population-Based Cohort Study

Comparative Persistence of the TNF Antagonists in Rheumatoid Arthritis – A Population-Based Cohort Study

The usage of biological DMARDs and clinical remission of rheumatoid arthritis in China: a real-world large scale study

Immediate adverse reactions to biologicals: from pathogenic mechanisms to prophylactic management

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