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Retention rates of adalimumab, etanercept and infliximab as first‐line biotherapy agent for rheumatoid arthritis patients in daily practice ‐ Auvergne experience
Author(s) -
Soubrier Martin,
Pereira Bruno,
Frayssac Thomas,
Fan Angelique,
Couderc Marion,
MalochetGuinamand Sandrine,
Mathieu Sylvain,
Tatar Zuzana,
Tournadre Anne,
Dubost JeanJacques
Publication year - 2018
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13156
Subject(s) - medicine , adalimumab , infliximab , etanercept , rheumatoid arthritis , antirheumatic agents , biosimilar , antirheumatic drugs , arthritis , physical therapy , dermatology , tumor necrosis factor alpha
Objective To compare, in real‐life conditions, the retention rates of anti‐tumor necrosis factor (anti‐TNF) treatment (etanercept [ETN], adalimumab [ADA] and infliximab [IFX]) initiated as first‐line biotherapy for rheumatoid arthritis (RA) and to evaluate, in case of failure, the switch to another anti‐TNF or a non‐anti‐TNF biological. Methods Monocentric retrospective cohort including all patients with RA starting a first anti‐TNF between 2001 and 2015. Results Among the 346 patients analyzed, 201 received ETN, 82 ADA and 63 IFX. The first anti‐TNF was interrupted in 151 cases. The retention rates were 82.8%, 67.6%, 46.5%, 28.1% and 22.5% at 1, 2, 5, 10 and 15 years, respectively, with a median retention duration of 52.8 (18.9–136.2) months (ETN: 59.3 [19.1–NA), ADA: 79.9 [19.3–136.2] and IFX: 37.2 [17.5–134.5], P = 0.49). The predictive factors of discontinuation were active RA (Disease Activity Score of 28 joints – C‐reactive protein [DAS28‐CRP] hazards ratio [HR]: 1.22 [1.03–1.45]), inflammatory syndrome (erythrocyte sedimentation rate HR: 1.01 [1.0–1.02]; CRP HR: 1.00 [1.00–1.01]), absence of methotrexate treatment (HR: 0.60 [0.43–0.83]), and corticosteroid use (HR: 1.91 [1.31–2.78]). The patients who switched to another anti‐TNF treatment had an inferior retention than those who switched to a non‐anti‐TNF treatment (HR: 0.39 [0.17–0.87], P = 0.02). Conclusion In real life, there was no difference in retention among the three anti‐TNF agents, and 25% of patients continued them at 15 years. After failure of an anti‐TNF, the switch to a non‐anti‐TNF biotherapy showed better retention.