Changes in Tumor Necrosis Factor Inhibitor Drug Survival in Patients With Rheumatoid Arthritis, Psoriatic Arthritis, and Ankylosing Spondylitis Over 15 Years
Authors' conclusion
Patients with RA, PsA, and AS currently initiating biologic (TNFi) therapy discontinue the drug much sooner than those starting shortly after the drugs were introduced.
Study context
- Population
- Patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) starting first biologic (TNFi) therapy in routine care, Amsterdam Rheumatology and Immunology Center, Reade, the Netherlands, 2004–201963% RA, 19% PsA, 19% AS
- Participants
- 1,938 patients
- Exposure
- TNFi starts in early vs intermediate vs recent periods; RA vs PsA vs AS
- Outcome
- Drug survival (retention) of first TNFi therapy
Methodological detailsroutine care, single-centre, Kaplan-Meier and log-rank tests, Cox regression
- Routine care
- Single-centre
- Kaplan-Meier and log-rank tests
- Cox regression
Main finding
As reported in the abstract
TNFi drug continuation by start period
Each group vs recentHazard ratio (95% CI)P value
Early
2.04(1.71–2.43)
P < 0.001Intermediate
1.92(1.58–2.35)
P < 0.001- Drug survival decreased significantly over time, mostly caused by decreases in the most recent 4-year period
- overall P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| TNFi drug continuation by diagnosisRAvs PsA | 0.58 (0.47–0.73) | P < 0.001 | |
| TNFi drug continuation by diagnosisRAvs AS | 0.63 (0.51–0.78) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
- TNFi drug continuation by diagnosis — Drug survival time significantly different between diseases, mostly caused by shorter survival in RA
- overall P < 0.001
Original publication
Changes in Tumor Necrosis Factor Inhibitor Drug Survival in Patients With Rheumatoid Arthritis, Psoriatic Arthritis, and Ankylosing Spondylitis Over 15 Years. J Rheumatol. Published 15 September 2023. doi:10.
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