Factors affecting discontinuation of adalimumab and etanercept therapy in anti-TNF-naïve patients with ankylosing spondylitis: Nationwide population-based cohort study. Issue 6 (8th September 2015)

• Record Type: Journal Article
• Authors: Chen, Hsin-Hua; Chen, Yi-Ming; Lai, Kuo-Lung; Lin, Ching-Heng; Tang, Chao-Hsiung; Chen, Der-Yuan
• Is Part Of: Modern rheumatology. Volume 25:Issue 6(2015)
• Page Start: 903
• Page End: 907
• Publication Date: 2015-09-08
• Subjects: Adalimumab -- Ankylosing spondylitis -- Etanercept -- Methotrexate -- Treatment discontinuation -- Tumor necrosis factor-α; Rheumatology -- Periodicals; 616.723005
• DOI: 10.3109/14397595.2015.1038426
• Languages: English
• ISSNs: 1439-7595

Abstract

Abstract : Objectives. We investigated factors associated with discontinuation of anti-tumor necrosis factor (TNF) therapy in patients with ankylosing spondylitis (AS), who were anti-TNF-naïve and were given etanercept (ETN) or adalimumab (ADA). Methods. This is a retrospective nationwide population-based cohort study. We identified 1401 anti-TNF-naïve patients with AS who initiated ETN ( n = 441) or ADA ( n = 960) and measured the duration of anti-TNF drug use. We recorded demographic and clinical data of all patients, and calculated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazard regression analyses. Results . Overall, the ADA and ETN groups had similar risk for drug discontinuation (HR: 0.83; 95% CI: 0.63–1.08). In each group, concomitant use of methotrexate (MTX) or a non-steroidal anti-inflammatory drug was associated with a lower risk of discontinuation. Subgroup analysis indicated that concomitant MTX use reduced risk of discontinuation of ADA (HR: 0.54; 95% CI: 0.40–0.74), but not ETN (HR: 1.03; 95% CI: 0.65–1.63). Conclusions. This study of anti-TNF-naïve patients with AS indicated that users of ADA and ETN had similar overall risk of drug discontinuation. However, patients taking ADA with MTX had a lower risk of discontinuation than those taking ADA alone.