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Retention rates of adalimumab, etanercept, and infliximab as first‐ or second‐line biotherapies for spondyloarthritis patients in daily practice in Auvergne (France)
Author(s) -
Soubrier Martin,
Pereira Bruno,
Fan Angelique,
Frayssac Thomas,
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.13375
Subject(s) - medicine , adalimumab , etanercept , infliximab , basdai , discontinuation , ankylosing spondylitis , concomitant , hazard ratio , retention rate , proportional hazards model , surgery , gastroenterology , tumor necrosis factor alpha , rheumatoid arthritis , confidence interval , computer security , psoriatic arthritis , computer science
Objective To compare, in real‐life settings, the retention rates of initial anti‐tumor‐necrosis factor ( TNF ) treatments (etanercept [ ETN ], adalimumab [ ADA ] and infliximab [ IFX ]) used as first‐line biotherapy for axial spondyloarthritis (axSpA), and evaluate treatment switches to another anti‐ TNF inhibitor in the event of treatment failure. Methods We analyzed the medical records of all SpA patients (Assessment in Ankylosing Spondylitis International Working Group axial criteria) treated with ETN , IFX or ADA between 2001 and February 2015. Drug retention rates were calculated using the Kaplan‐Meier method and compared by means of the Cox extended model. Sub‐analyses were performed according to discontinuation reasons. Results Of the 249 SpA patients analyzed (135 radiographic cases, 114 non‐radiographic), 102 received ETN , 62 ADA , and 85 IFX . In total, 103 discontinued treatment. The retention rates of IFX , ADA and ETN were 67%, 59% and 56% after 3 years; 62%, 42% and 47% after 5 years; 55%, 42% and 24% after 8 years; 53%, 42% and 12% after 10 years, respectively. In multivariate analyses, the predictive factors for retention were: low BASDAI score (hazard ratio [ HR ]: 1.02 [1.01‐1.04]), high C‐reactive protein levels ( HR : 0.98 [0.97‐0.99]), concomitant disease‐modifying therapy ( HR : 0.4 [0.21‐0.75]), and radiographic SpA ( HR : 1.5 [1.0‐2.52]). In total, 61 patients switched to another anti‐ TNF therapy. No difference was observed among the three anti‐ TNF therapies regarding median retention duration, although the retention rate proved higher for treatment switches from one monoclonal antibody to another. Conclusion The retention rate in SpA patients proved high, with retention for IFX superior to that of ETN .