Difference In Drug Survival Research Articles

AB0774 Does prescription year influence the pattern of biologics use for rheumatoid arthritis?

BackgroundChoice and pattern of use of biological therapies in rheumatoid arthritis (RA) depends on many factors. Distinct timing of availability in the market as well as of supportive scientific information...

Optimal Public Goods Provision: Implications of Endogenizing the Labor/Leisure Choice

<h3>Background</h3> “Head to head” studies comparing the efficacy and tolerability of different TNF inhibitors are scarce, in particular the comparison between certolizumab pegol and golimumab. <h3>Objectives</h3> To compare the efficaciousness, drug survival and tolerability of certolizumab-pegol and golimumab in adult patients with establish arthritis (RA, JIA, SpA or unspecified polyarthritis) starting these treatments between February 2010 and December 2013 at out-patient unit at the Skåne University Hospital, Department of Rheumatology Lund/Malmö and two associated private rheumatology units. <h3>Methods</h3> All patients starting treatment with biologics were consecutively included in the South Swedish Arthritis Treatment Group (SSATG) register and regularly followed up according the standard protocol including: SJC/TJC, CRP, ESR, physicians global assessment of disease activity, patients9 assessment of disease activity and pain (VAS global and VAS pain) and HAQ. Last follow up date was October 17th 2016. Kaplan-Meier survival analysis was used to estimate the drug survival. Possible predictors of drug survival were analysed using Cox regression model. <h3>Results</h3> In total, 352 patients (71% women, mean age 51 years, mean disease duration 12 years, started these treatments during study period. Of these, 168 received golimumab and 184 certulizumab-pegol. Mean treatment time was 31 months (range 0–77). Percentage of patients with RA, SpA, JIA and unspecified arthritis were 58,4%, 16,4%, 5,7%, and 19,5% respectively. Certolizumab-pegol was more used in RA (67% vs 49%) and JIA (8% vs 2%) while golimumab was more frequent among patients with SpA (21% and 12%) or PsA (23% and 10, respectively). Only 7% of golimumab and 10% of certulizumab-pegol patients received these drugs as first biologic treatment and approximately 50% of patients received these drugs as ≥3. biological treatment. In golimumab treated patients mean DAS28 decreased from 4,3 (baseline) to 3,3 (3 months); 2,8 (6 months) and 2,7 (12 months) but levelled off at 36 months follow up. Corresponding mean DAS28 levels in certulizumab-pegol treated patients were 4,6 (baseline); 3,2 (3 months); 2,8 (6 months) and 2,6 (12 months). The similar pattern was seen in changes in HAQ and CDAI over the study time. There were no statistically significant differences in DAS, HAQ or CDAI between treatments at any follow up visit. At the end of follow up 64 (38%) of golimumab and 60 (32%) of certulizumab-pegol patients remained on their treatment. No significant difference in drug survival was seen between the treatments (Figure). Patients with spondylartropathy had significantly better survival on golimumab compared to RA patients (p=0,005)whicih remained after adjustment for age, gender, CRP, number of previous biologics and concomitnt methotrexate at baseline. <h3>Conclusions</h3> Spondylarthropathy including psoriatic arthritis was associated with better drug survival on golimunab compared to certolizumab pegol. No other significant differences in efficacy, tolerability or drug survival were seen between golimumab and certolizumab pegol in patients with established arthritis in daily clinical practice. Approximately one third of patients starting these treatments remained on treatment after 3 years. <h3>Disclosure of Interest</h3> None declared

The comparative one‐year performance of anti–tumor necrosis factor α drugs in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: Results from a longitudinal, observational, multicenter study

To compare the 1-year retention rates of anti-tumor necrosis factor alpha (anti-TNFalpha) medications in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) with complementary analyses of the effect on health status. Our analyses comprised 847, 172, and 249 anti-TNFalpha treatment courses in patients with RA, PsA, and AS, respectively. Crude drug survival was compared and hazard ratios (HRs) for treatment termination were calculated with adjustments for age, sex, investigator's global assessment, and concomitant methotrexate (MTX). Adjusted changes in health-related quality of life (HRQOL) were compared among the groups. Unadjusted 1-year retention rates were 65.4%, 77.3%, and 77.5% in the RA, PsA, and AS groups, respectively. The adjusted HRs for treatment termination were 0.76 (95% confidence interval [95% CI] 0.53-1.07) for PsA versus RA and 0.66 (95% CI 0.47-0.92) for AS versus RA. High baseline disease activity and female sex were significantly associated with premature treatment termination, whereas concomitant MTX was associated with better drug survival. However, the impact of MTX was apparent for RA and PsA, but not for AS in stratified analyses. The improvements in HRQOL were superior in patients with PsA and AS compared with RA. Our results suggest that survival of anti-TNFalpha treatment is superior in AS and PsA patients compared with RA patients. Larger improvements in HRQOL in patients with spondylarthritides may contribute to the differences in drug survival. Concomitant MTX was associated with better retention rates in RA and PsA patients, but not AS patients.

The influence of previous and concomitant leflunomide on the efficacy and safety of infliximab therapy in patients with rheumatoid arthritis; a longitudinal observational study

To investigate the influence of previous and concomitant leflunomide on the efficacy and safety of infliximab therapy in rheumatoid arthritis (RA) and to compare it to infliximab in combination with other disease-modifying anti-rheumatic drugs. RA patients starting infliximab therapy were prospectively followed from January 2000. Every 3 months data were collected regarding disease activity (DAS28), adverse events and treatment changes. In the primary analyses all patients were classified into a leflunomide group (LEF group) if they had used leflunomide during infliximab therapy or within 6 months prior to starting infliximab therapy, the latter because of the long half-life of leflunomide. All other patients were considered as controls (non-LEF group). Secondary drug survival analyses were performed with the LEF group consisting only of patients on active leflunomide at the start of infliximab (active LEF group). A total of 162 RA patients started infliximab therapy (57 in the LEF group, 105 in the non-LEF group). No statistically significant differences in baseline characteristics were observed between the groups. Maximum follow-up time was 46 months for both groups. No differences in drug survival, disease activity or adverse events were observed between the groups. In both groups an increase in patients positive for antinuclear antibodies (ANA) was seen. ANA positivity at start did not predict DAS28 or the occurrence of adverse events. Secondary drug survival analyses showed no differences between the active LEF group and the non-LEF group. The results indicate that the administration of infliximab after or simultaneously with leflunomide is safe and efficacious in RA patients.

Survival during treatment with tumour necrosis factor blocking agents in rheumatoid arthritis

Tumour necrosis factor (TNF) blocking agents are an important advance in the clinical treatment of rheumatoid arthritis (RA). They were introduced into clinical practice while limited safety information was available....