Factors Affecting Survival on Biologic Treatments in Patients with Rheumatoid Arthritis: A Single-Center Study From Turkey

Abstract

Objective: In our study, we aimed to determine the factors affecting survival on biologic treatment in adult rheumatoid arthritis (RA) patients using biolog- ical drugs. Materials and Methods: In our study, the data of 245 patients who were followed up with the diagnosis of RA in the Rheumatology Clinic of Trakya University Medical Faculty Hospital between 2013 and 2016 were analyzed retrospectively. 37 patients were excluded due to missing data. The data of the remaining 208 patients were evaluated. Results: In our study, we found that drug survival was reduced by 0.48 times (95% CI 0.23-0.97) in elderly patients and 3 times (95% CI 1.09-10.3) in females. According to the results of our study, drug survival is shortened 8 times (95% CI 2.12-32.5) in patients with hyperlipidemia and 1.03 times (95% CI 1.01-1.04) in patients with high pretreatment erythrocyte sedimentation rate (ESR). In addition, we found that shorter drug survival 9.2 times (95% CI 2.4-35.3) in patients with Hepatitis B surface antigen (HBsAg) positivity, 2.9 times (95% CI 1.3-6.4) in patients with antibody positivity against citrullinated protein (ACPA), in patients using glucocorticoids 0.36 times (95% CI 0.17-0.76). Despite that; in patients with chronic kidney disease, drug survival was prolonged by 0.18 times (95% CI 0.06-0.57). Conclusion: When starting biologic drugs in RA patients, some parameters may help to predict drug survival. According to the order of effect; while HBsAg positivity, presence of hyperlipidemia, female gender, ACPA positivity, high ESR, advanced age and glucocorticoid use were negative markers for drug survival; chronic kidney damage can be a positive marker.