Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study.
RMD Open
; 9(3)2023 08.
Article
em En
| MEDLINE
| ID: mdl-37597846
ABSTRACT
OBJECTIVES:
This multicentre retrospective study in Japan aimed to assess the retention of biological disease-modifying antirheumatic drugs and Janus kinase inhibitors (JAKi), and to clarify the factors affecting their retention in a real-world cohort of patients with rheumatoid arthritis.METHODS:
The study included 6666 treatment courses (bDMARD-naïve or JAKi-naïve cases, 55.4%; tumour necrosis factor inhibitors (TNFi) = 3577; anti-interleukin-6 receptor antibodies (aIL-6R) = 1497; cytotoxic T lymphocyte-associated antigen-4-Ig (CTLA4-Ig) = 1139; JAKi=453 cases). The reasons for discontinuation were divided into four categories (ineffectiveness, toxic adverse events, non-toxic reasons and remission); multivariate Cox proportional hazards modelling by potential confounders was used to analyse the HRs of treatment discontinuation.RESULTS:
TNFi (HR=1.93, 95% CI 1.69 to 2.19), CTLA4-Ig (HR=1.42, 95% CI 1.20 to 1.67) and JAKi (HR=1.29, 95% CI 1.03 to 1.63) showed a higher discontinuation rate due to ineffectiveness than aIL-6R. TNFi (HR=1.28, 95% CI 1.05 to 1.56) and aIL-6R (HR=1.27, 95% CI 1.03 to 1.57) showed a higher discontinuation rate due to toxic adverse events than CTLA4-Ig. Concomitant use of oral glucocorticoids (GCs) at baseline was associated with higher discontinuation rate due to ineffectiveness in TNFi (HR=1.24, 95% CI 1.09 to 1.41), as well as toxic adverse events in JAKi (HR=2.30, 95% CI 1.23 to 4.28) and TNFi (HR=1.29, 95%CI 1.07 to 1.55).CONCLUSIONS:
TNFi (HR=1.52, 95% CI 1.37 to 1.68) and CTLA4-Ig (HR=1.14, 95% CI 1.00 to 1.30) showed a higher overall drug discontinuation rate, excluding non-toxicity and remission, than aIL-6R.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Produtos Biológicos
/
Inibidores de Janus Quinases
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article