Aline Frazier-Mironer1, Maxime Dougados2, Xavier Mariette3, Alain Cantagrel4, Véronique Deschamps5, René Marc Flipo6, Isabelle Logeart5, Thierry Schaeverbeke7, Jean Sibilia8, Xavier Le Loët9, Bernard Combe10. 1. Fédération de rhumatologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France. 2. Rheumatology B Department, Paris-Descartes University, AP-HP, Cochin Hospital, 27, rue du faubourg Saint-Jacques, 75014 Paris, France. 3. Rheumatology, université Paris-Sud, hôpitaux universitaires Paris-Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le-Kremlin-Bicêtre, France. 4. Dept of Rheumatology, hôpital Purpan, place du Dr-Baylac, Toulouse cedex 9, France. 5. Pfizer France, 23-25, avenue du Docteur-Lannelongue, 75014 Paris, France. 6. Rheumatology Department, Lille 2 University, hopital R-Salengro, CHRU, 2, rue Émile-Laine, 59037 Lille cedex, France. 7. Service de rhumatologie, groupe hospitalier Pellegrin, 6, place Amélie-Raba-Leon, 33076 Bordeaux, France. 8. Service de rhumatologie, CHU de Strasbourg, hôpital Hautepierre, 67098 Strasbourg cedex, France. 9. Rheumatology Department, Rouen University hospital and Inserm, U 905, Institute for Research and Innovation in Biomedicine (IRIB), Rouen University, Rouen, France. 10. Departement de rheumatologie, hôpital Lapeyronie, 371, avenue du doyen Gaston-Giraud, 34295 Montpellier cedex 5, France. Electronic address: b-combe@chu-montpellier.fr.
Abstract
OBJECTIVES: To compare retention rates of adalimumab, etanercept and infliximab as first-line biotherapy in rheumatoid arthritis (RA), to determine causes of discontinuation, retention-associated factors, and retention rates of possible second-line TNF-α inhibitors (TNFi). METHODS: In this retrolective, multicentric study, medical charts of RA patients starting TNFi between March 2005 and April 2009 were reviewed, with follow-up between two and six years. The retention rate was estimated using the Kaplan-Meier method. Comparison between TNFi was done after adjustment using a Cox model. Factors associated with better retention were identified by multivariate analysis. RESULTS: Of the 706 patients included, the percentage continuing treatment after two years was 54.9, 61.9 and 48.7%, and the median retention was 31, 45 and 23 months for adalimumab, etanercept and infliximab, respectively. The hazard ratios (HRs) for discontinuation were greater with adalimumab and infliximab than etanercept (1.315, 95% CI [1.050-1.648] and 1.380, 95% CI [1.041-1.828], respectively). The HR for discontinuation due to inefficacy was significantly higher with adalimumab than etanercept. Adverse events were significantly higher with infliximab than etanercept. Past use of more DMARDs and higher baseline ESR were associated with better retention. The median retention of the second-line TNFi was 11, 43 and 19.1 months for adalimumab, etanercept, and infliximab, respectively. HRs for adalimumab discontinuation due to all causes were significantly greater than for etanercept. CONCLUSIONS: Etanercept had a better retention rate than adalimumab and infliximab as first-line biotherapy in RA, and than adalimumab as second-line biotherapy.
OBJECTIVES: To compare retention rates of adalimumab, etanercept and infliximab as first-line biotherapy in rheumatoid arthritis (RA), to determine causes of discontinuation, retention-associated factors, and retention rates of possible second-line TNF-α inhibitors (TNFi). METHODS: In this retrolective, multicentric study, medical charts of RApatients starting TNFi between March 2005 and April 2009 were reviewed, with follow-up between two and six years. The retention rate was estimated using the Kaplan-Meier method. Comparison between TNFi was done after adjustment using a Cox model. Factors associated with better retention were identified by multivariate analysis. RESULTS: Of the 706 patients included, the percentage continuing treatment after two years was 54.9, 61.9 and 48.7%, and the median retention was 31, 45 and 23 months for adalimumab, etanercept and infliximab, respectively. The hazard ratios (HRs) for discontinuation were greater with adalimumab and infliximab than etanercept (1.315, 95% CI [1.050-1.648] and 1.380, 95% CI [1.041-1.828], respectively). The HR for discontinuation due to inefficacy was significantly higher with adalimumab than etanercept. Adverse events were significantly higher with infliximab than etanercept. Past use of more DMARDs and higher baseline ESR were associated with better retention. The median retention of the second-line TNFi was 11, 43 and 19.1 months for adalimumab, etanercept, and infliximab, respectively. HRs for adalimumab discontinuation due to all causes were significantly greater than for etanercept. CONCLUSIONS: Etanercept had a better retention rate than adalimumab and infliximab as first-line biotherapy in RA, and than adalimumab as second-line biotherapy.
Authors: Ignacio Ortea; Bernd Roschitzki; Rosario López-Rodríguez; Eva G Tomero; Juan G Ovalles; Javier López-Longo; Inmaculada de la Torre; Isidoro González-Alvaro; Juan J Gómez-Reino; Antonio González Journal: PLoS One Date: 2016-04-06 Impact factor: 3.240
Authors: Anat Fisher; Ken Bassett; Gautam Goel; Dana Stanely; M Alan Brookhart; Hugh R Freeman; James M Wright; Colin R Dormuth Journal: PLoS One Date: 2016-12-08 Impact factor: 3.240
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