Retention rates of adalimumab, etanercept and infliximab as first‐line biotherapy agent for rheumatoid arthritis patients in daily practice ‐ Auvergne experience. (13th September 2017)

• Record Type: Journal Article
• Authors: Soubrier, Martin; Pereira, Bruno; Frayssac, Thomas; Fan, Angelique; Couderc, Marion; Malochet‐Guinamand, Sandrine; Mathieu, Sylvain; Tatar, Zuzana; Tournadre, Anne; Dubost, Jean‐Jacques
• Is Part Of: International journal of rheumatic diseases. Volume 21:Number 11(2018)
• Page Start: 1924
• Page End: 1932
• Publication Date: 2017-09-13
• Subjects: drug treatment -- rheumatoid arthritis; Rheumatology -- Periodicals; Rheumatology -- Asia -- Periodicals; Rheumatology -- Pacific Area -- Periodicals; Rheumatic Diseases -- Periodicals; Connective Tissue Diseases -- Periodicals; Immune System Diseases -- Periodicals; 616.723
• DOI: 10.1111/1756-185X.13156
• Languages: English
• ISSNs: 1756-1841

Abstract

Abstract: 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.