Retention rates of adalimumab, etanercept and infliximab as first-line biotherapy agent for rheumatoid arthritis patients in daily practice - Auvergne experience
Corresponding Author
Martin Soubrier
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Correspondence: Prof. Martin Soubrier, MD PhD Rheumatology Department, CHU GABRIEL MONTPIED, Clermont-Ferrand, France. Email: [email protected]Search for more papers by this authorBruno Pereira
Biostatistics Unit (DRCI), Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorThomas Frayssac
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorAngelique Fan
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorMarion Couderc
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorSandrine Malochet-Guinamand
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorSylvain Mathieu
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorZuzana Tatar
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorAnne Tournadre
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorJean-Jacques Dubost
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorCorresponding Author
Martin Soubrier
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Correspondence: Prof. Martin Soubrier, MD PhD Rheumatology Department, CHU GABRIEL MONTPIED, Clermont-Ferrand, France. Email: [email protected]Search for more papers by this authorBruno Pereira
Biostatistics Unit (DRCI), Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorThomas Frayssac
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorAngelique Fan
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorMarion Couderc
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorSandrine Malochet-Guinamand
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorSylvain Mathieu
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorZuzana Tatar
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorAnne Tournadre
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorJean-Jacques Dubost
Rheumatology Department, Chu Hôpital Gabriel Montpied, Clermont-Ferrand, France
Search for more papers by this authorAbstract
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.
Supporting Information
| Filename | Description |
|---|---|
| apl13156-sup-0001-FigS1.docWord document, 40.5 KB | Figure S1. Survival curves of the three anti-TNFs regarding treatment discontinuation because of undesirable effects. |
| apl13156-sup-0002-FigS2.docWord document, 40.5 KB | Figure S2. Survival curves of the three anti-TNFs regarding discontinuation due to inefficacy. |
| apl13156-sup-0003-FigS3.docWord document, 40 KB | Figure S3. Survival curves following first anti-TNF failure when switching from a monoclonal antibody to etanercept or vice versa. |
| apl13156-sup-0004-TableS1.docWord document, 49 KB | Table S1. Prognostic factors at baseline for cessation of first treatment because of adverse effects |
| apl13156-sup-0005-TableS2.docWord document, 49.5 KB | Table S2. Predictive factors at baseline of discontinuation of the first treatment due to inefficacy |
| apl13156-sup-0006-TableS3.docWord document, 52.5 KB | Table S3. Comparative analysis according to eular response |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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