PMID- 37431434
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230718
IS  - 2514-1775 (Electronic)
IS  - 2514-1775 (Linking)
VI  - 7
IP  - 2
DP  - 2023
TI  - Discontinuation rate of sulfasalazine, leflunomide and methotrexate due to 
      adverse events in a real-life setting (NOR-DMARD).
PG  - rkad053
LID - 10.1093/rap/rkad053 [doi]
LID - rkad053
AB  - OBJECTIVES: MTX, LEF and SSZ are conventional synthetic DMARDs (csDMARDs) with a 
      well-established role in the treatment of RA. We aimed to estimate and compare 
      the relative risks for adverse events (AEs) and the discontinuation of these 
      drugs owing to AEs. METHODS: We included all 3339 patients from the NOR-DMARD 
      study treated with MTX, LEF or SSZ in monotherapy. All reported AEs were compared 
      between treatment groups using quasi-Poisson regression. In addition, drug 
      retention rates were analysed using Kaplan-Meier estimates with Cox regression to 
      control for possible confounders. We analysed drug retention rates and cumulative 
      risk of discontinuation attributable to AEs using the Kaplan-Meier estimator. We 
      assessed age, sex, baseline DAS in 28 joints with ESR (DAS28-ESR), 
      seropositivity, prednisolone use, previous DMARD use, year of inclusion and 
      co-morbidity as possible cofounders. RESULTS: We found that the discontinuation 
      rate attributable to AEs was significantly higher for LEF and SSZ than for MTX. 
      After the first year, it was 13.7% (95% CI 12.2, 15.2), 39.6% (95% CI 34.8, 44) 
      and 43.4% (95% CI 38.2, 48.1) for MTX, SSZ and LEF, respectively. Similar results 
      were found when adjusting for confounders. The overall AEs were comparable across 
      the treatment groups. The AE profile was as expected for each drug. CONCLUSION: 
      Our work has shown a similar AE profile of csDMARDs to previous data. However, 
      higher discontinuation rates for SSZ and LEF cannot be explained easily from AE 
      profiles.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      British Society for Rheumatology.
FAU - Mielnik, Pawel
AU  - Mielnik P
AUID- ORCID: 0000-0002-3894-5371
AD  - Section for Rheumatology, Department for Neurology, Rheumatology and Physical 
      Medicine, Helse Forde, Forde, Norway.
FAU - Sexton, Joseph
AU  - Sexton J
AD  - Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), 
      Diakonhjemmet Hospital, Oslo, Norway.
FAU - Fagerli, Karen M
AU  - Fagerli KM
AD  - Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), 
      Diakonhjemmet Hospital, Oslo, Norway.
FAU - Bakland, Gunnstein
AU  - Bakland G
AD  - Department of Rheumatology, University Hospital of Northern Norway, Tromso, 
      Norway.
FAU - Hu, Yi
AU  - Hu Y
AD  - Lillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway.
FAU - Kristianslund, Eirik K
AU  - Kristianslund EK
AD  - Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), 
      Diakonhjemmet Hospital, Oslo, Norway.
FAU - Hoff, Mari
AU  - Hoff M
AD  - Department of Rheumatology, St. Olavs Hospital, Trondheim, Norway.
AD  - Department of Neuromedicine and Movement Science, NTNU-Norwegian University of 
      Science and Technology, Trondheim, Norway.
FAU - Wierod, Ada
AU  - Wierod A
AD  - Department of Rheumatology, Vestre Viken/Drammen Hospital, Drammen, Norway.
FAU - Kvien, Tore K
AU  - Kvien TK
AD  - Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), 
      Diakonhjemmet Hospital, Oslo, Norway.
AD  - Faculty of Medicine, University of Oslo, Oslo, Norway.
LA  - eng
PT  - Journal Article
DEP - 20230616
PL  - England
TA  - Rheumatol Adv Pract
JT  - Rheumatology advances in practice
JID - 101736676
PMC - PMC10329773
OTO - NOTNLM
OT  - LEF
OT  - MTX
OT  - RA
OT  - SSZ
OT  - adverse events
OT  - discontinuation
EDAT- 2023/07/11 06:41
MHDA- 2023/07/11 06:42
PMCR- 2023/06/16
CRDT- 2023/07/11 03:37
PHST- 2023/01/26 00:00 [received]
PHST- 2023/06/05 00:00 [accepted]
PHST- 2023/07/11 06:42 [medline]
PHST- 2023/07/11 06:41 [pubmed]
PHST- 2023/07/11 03:37 [entrez]
PHST- 2023/06/16 00:00 [pmc-release]
AID - rkad053 [pii]
AID - 10.1093/rap/rkad053 [doi]
PST - epublish
SO  - Rheumatol Adv Pract. 2023 Jun 16;7(2):rkad053. doi: 10.1093/rap/rkad053. 
      eCollection 2023.