The long‐term persistence of tumor necrosis factor inhibitors in patients with moderate to severe immune‐mediated rheumatic diseases: A nation‐wide, population‐based real‐world study

Abstract

Objectives We aimed to compare the long‐term persistence between different tumor necrosis factor‐alpha inhibitors (TNFis) with immune‐mediated rheumatic diseases (IMRD). This study can potentially provide insights into the real‐world evidence regarding safety and effectiveness of TNFi treatment in a Chinese population. Methods We enrolled newly diagnosed IMRD patients in this active comparator, retrospective cohort study by using National Taiwan insurance claim datasets. The drug survivals of first‐line TNFi agents, including etanercept, golimumab, and adalimumab were compared. Propensity score matching was conducted to control the confounding effect from the observed covariates. The cumulative proportion of discontinuation was calculated over 5 years. The multiple‐variable regression and propensity score analysis was used for confounding adjustment. Results After propensity score matching, there were 2267 patients identified in each etanercept, golimumab, and adalimumab group. We observed the 5‐year cumulative proportion of discontinuation was 52.80%, 45.85%, and 56.86% in etanercept, golimumab, and adalimumab, respectively. Compared with golimumab, increase of 31% (95% CI: 20‐43) and 38% (95% CI: 26‐50) risk of discontinuation were observed in etanercept and adalimumab. The factors including female gender, increasing age, long hospital stays, without co‐medication with nonsteroidal anti‐inflammatory drugs or methotrexate were associated were discontinuation of first‐line TNFi treatment. Conclusion Golimumab had better drug survival than etanercept or adalimumab over 5 years of observation in Asian IMRD patients. Gender, age, longer hospital stays, concomitant use of disease‐modifying antirheumatic drugs were associated with survival with TNFis.

Long‐term efficacy, safety, and cumulative retention rate of antitumor necrosis factor‐alpha treatment for patients with Behcet's uveitis: A systematic review and meta‐analysis

“…26,27 In addition, there is evidence that anti-TNFα agents have beneficial effects other rheumatic diseases such as ankylosing spondylitis (AS), rheumatoid arthritis (RA), and psoriatic arthritis (PsA). [28][29][30] Usually, patients with BU exhibit significantly higher levels of TNFα in their serum and eyes compared to those with other causes of uveitis. 31 A prior meta-analysis conducted in 2020 confirmed the efficacy of anti-TNFα agents in BU.…”

“…Due to the unique role of TNF‐α in BD, 25 anti‐TNF‐α agents have been employed in the treatment of refractory BD, including conditions like neuro‐Behcet's disease and vascular involvement in Behcet's syndrome, and have demonstrated effectiveness 26,27 . In addition, there is evidence that anti‐TNF‐α agents have beneficial effects on other rheumatic diseases such as ankylosing spondylitis (AS), rheumatoid arthritis (RA), and psoriatic arthritis (PsA) 28–30 . Usually, patients with BU exhibit significantly higher levels of TNF‐α in their serum and eyes compared to those with other causes of uveitis 31 .…”

Risk of dyslipidemia and major adverse cardiac events with tofacitinib versus adalimumab in rheumatoid arthritis: a real-world cohort study from 7580 patients

“…Tofacitinib is an oral small molecule Janus kinase (JAK) inhibitor that interferes with inflammatory cytokine signaling pathways (Zhu et al, 2021). In contrast, adalimumab is an injectable tumor necrosis factor-alpha (TNF-α) inhibitor monoclonal antibody biologic that directly targets inflammatory cells and cytokines (Zullow et al, 2014;Panaccione et al, 2021;Huang et al, 2022;Zouboulis et al, 2023). Both drugs are widely used either alone or in combination strategies to manage RA symptoms and slow disease progression, often in side-by-side comparative studies (Zhang et al, 2014;Fleischmann et al, 2017;Deakin et al, 2023).…”