TNF‐α Antagonist Survival Rate in a Cohort of Rheumatoid Arthritis Patients Observed under Conditions of Standard Clinical Practice
- 1 September 2009
- journal article
- Published by Wiley in Annals of the New York Academy of Sciences
- Vol. 1173 (1), 837-846
- https://doi.org/10.1111/j.1749-6632.2009.04621.x
Abstract
A cohort of rheumatoid arthritis (RA) patients in the Lombardy Rheumatology Network (LOHREN) registry and receiving anti‐TNF therapy was evaluated after 6, 12, 24, and 36 months. Of the 1114 patients in the registry 1064 met the clinical criteria for inclusion with 519 receiving infliximab, 303 adalimumab, and 242 etanercept. The therapeutic survival curve of these patients showed that the likelihood of continuing anti‐TNF therapy was 78.8% after 12 months, 65.2% after 24 months, and 52.9% after 36 months, with a risk of dropout similar for inefficacy and adverse events. There were 405 anti‐TNF therapy discontinuations (38.1%): 180 (16.9%) due to inefficacy, 194 (18.2%) adverse events, and 31 (2.9%) other reasons. Four deaths (2 septicemia, 1 postinfective cerebritis, 1 heart failure) were considered to be related to anti‐TNF therapy. Of the discontinuations, 219 (54.1%) occurred within the first 12 months: 110 due to adverse events, 89 inefficacy, and 20 due to other reasons. After 36 months, the likelihood of survival on etanercept (62.5%) was significantly greater than the likelihood of survival on infliximab (49.1%) or adalimumab (53.6%). A higher risk of therapy discontinuations due to adverse events was associated with increasing age, a corticosteroid >5 mg/day, a high erythrocyte sedimentation rate (ESR), a higher risk of therapy discontinuations due to inefficacy was associated with the previous use of ≥4 disease‐modifying antirheumatic drugs (DMARDs) and a high ESR. Comorbidities, increasing DAS28 values and co‐therapy with methotrexate were associated with a lower risk of discontinuation.Keywords
This publication has 28 references indexed in Scilit:
- Biological and clinical effects of anti-TNFα treatmentAutoimmunity Reviews, 2007
- Anti–tumor necrosis factor α therapy and the risk of serious bacterial infections in elderly patients with rheumatoid arthritisArthritis & Rheumatism, 2007
- Tolerance and effectiveness of anti–tumor necrosis factor α therapies in elderly patients with rheumatoid arthritis: A population‐based cohort studyArthritis Care & Research, 2007
- Predictors of response to anti-TNF- therapy among patients with rheumatoid arthritis: results from the British Society for Rheumatology Biologics RegisterRheumatology, 2006
- Long term efficacy and safety of adalimumab plus methotrexate in patients with rheumatoid arthritis: ARMADA 4 year extended studyAnnals Of The Rheumatic Diseases, 2006
- Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti–tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: A randomized, placebo‐controlled, 52‐week trialArthritis & Rheumatism, 2004
- Survival during treatment with tumour necrosis factor blocking agents in rheumatoid arthritisAnnals Of The Rheumatic Diseases, 2003
- Etanercept, infliximab, and leflunomide in established rheumatoid arthritis: clinical experience using a structured follow up programme in southern SwedenAnnals Of The Rheumatic Diseases, 2002
- Infliximab for the treatment of rheumatoid arthritisEmergencias, 2002
- The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritisArthritis & Rheumatism, 1988