PMID- 19405000
OWN - NLM
STAT- MEDLINE
DCOM- 20090630
LR  - 20220409
IS  - 0004-3591 (Print)
IS  - 0004-3591 (Linking)
VI  - 61
IP  - 5
DP  - 2009 May 15
TI  - Comparison of drug retention rates and causes of drug discontinuation between 
      anti-tumor necrosis factor agents in rheumatoid arthritis.
PG  - 560-8
LID - 10.1002/art.24463 [doi]
AB  - OBJECTIVE: Tumor necrosis factor (TNF) inhibitors have revolutionized the 
      treatment of severe rheumatoid arthritis (RA), yet drug discontinuation is 
      common. The aim of this study was to compare treatment retention rates and 
      specific causes of anti-TNF discontinuation in a population-based RA cohort. 
      METHODS: All patients treated with etanercept, infliximab, or adalimumab within 
      the Swiss Clinical Quality Management RA cohort between 1997 and 2006 were 
      included in the study. Causes of treatment discontinuation were broadly 
      categorized as adverse events (AEs) or nontoxic causes, and further subdivided 
      into specific categories. Specific causes of treatment interruption were analyzed 
      using a Cox proportional hazards model and adjusted for potential confounders. 
      RESULTS: A total of 2,364 anti-TNF treatment courses met the inclusion criteria. 
      Treatment discontinuation was reported 803 times: 309 with etanercept, 249 with 
      infliximab, and 245 with adalimumab. Drug inefficacy represented the largest 
      single cause of treatment discontinuation (55.8% of cases). The median time of 
      receiving anti-TNF therapy was 37 months, but discontinuation rates differed 
      between the 3 anti-TNF agents (P < 0.001), with shorter retention rates for 
      infliximab (hazard ratio [HR] 1.24, 99% confidence interval [99% CI] 1.01-1.51). 
      The specific causes of treatment discontinuation revealed an increased risk of 
      AEs with infliximab (HR 1.4, 99% CI 1.003-1.96), mostly due to an increased risk 
      of infusion or allergic reactions (HR 2.11, 99% CI 1.23-3.62). Other 
      discontinuation causes were equally distributed between the anti-TNF agents. 
      CONCLUSION: In this population, infliximab was associated with higher overall 
      discontinuation rates compared with etanercept and adalimumab, which is mainly 
      due to an increased risk of infusion or allergic reactions.
FAU - Du Pan, Sophie Martin
AU  - Du Pan SM
AD  - Geneva University Hospital, Geneva, Switzerland. sophie.martin-du-pan@hcuge.ch
FAU - Dehler, Silvia
AU  - Dehler S
FAU - Ciurea, Adrian
AU  - Ciurea A
FAU - Ziswiler, Hans-Rudolf
AU  - Ziswiler HR
FAU - Gabay, Cem
AU  - Gabay C
FAU - Finckh, Axel
AU  - Finckh A
CN  - Swiss Clinical Quality Management Physicians
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arthritis Rheum
JT  - Arthritis and rheumatism
JID - 0370605
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - B72HH48FLU (Infliximab)
RN  - FYS6T7F842 (Adalimumab)
RN  - OP401G7OJC (Etanercept)
SB  - IM
MH  - Adalimumab
MH  - Adult
MH  - Aged
MH  - Antibodies, Monoclonal/*administration & dosage/adverse effects
MH  - Antibodies, Monoclonal, Humanized
MH  - Antirheumatic Agents/*administration & dosage/adverse effects
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Cohort Studies
MH  - Drug Hypersensitivity/etiology
MH  - Etanercept
MH  - Female
MH  - Humans
MH  - Immunoglobulin G/*administration & dosage/adverse effects
MH  - Infliximab
MH  - Kaplan-Meier Estimate
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Receptors, Tumor Necrosis Factor/*administration & dosage
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
EDAT- 2009/05/01 09:00
MHDA- 2009/07/01 09:00
CRDT- 2009/05/01 09:00
PHST- 2009/05/01 09:00 [entrez]
PHST- 2009/05/01 09:00 [pubmed]
PHST- 2009/07/01 09:00 [medline]
AID - 10.1002/art.24463 [doi]
PST - ppublish
SO  - Arthritis Rheum. 2009 May 15;61(5):560-8. doi: 10.1002/art.24463.