Retention rates of adalimumab, etanercept, and infliximab as first‐ or second‐line biotherapies for spondyloarthritis patients in daily practice in Auvergne (France)
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E-Artikel
Titel:
Retention rates of adalimumab, etanercept, and infliximab as first‐ or second‐line biotherapies for spondyloarthritis patients in daily practice in Auvergne (France)
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<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>To compare, in real‐life settings, the retention rates of initial anti‐tumor‐necrosis factor (<jats:styled-content style="fixed-case">TNF</jats:styled-content>) treatments (etanercept [<jats:styled-content style="fixed-case">ETN</jats:styled-content>], adalimumab [<jats:styled-content style="fixed-case">ADA</jats:styled-content>] and infliximab [<jats:styled-content style="fixed-case">IFX</jats:styled-content>]) used as first‐line biotherapy for axial spondyloarthritis (axSpA), and evaluate treatment switches to another anti‐<jats:styled-content style="fixed-case">TNF</jats:styled-content> inhibitor in the event of treatment failure.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We analyzed the medical records of all SpA patients (Assessment in Ankylosing Spondylitis International Working Group axial criteria) treated with <jats:styled-content style="fixed-case">ETN</jats:styled-content>,<jats:styled-content style="fixed-case"> IFX</jats:styled-content> or <jats:styled-content style="fixed-case">ADA</jats:styled-content> between 2001 and February 2015. Drug retention rates were calculated using the Kaplan‐Meier method and compared by means of the Cox extended model. Sub‐analyses were performed according to discontinuation reasons.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of the 249 SpA patients analyzed (135 radiographic cases, 114 non‐radiographic), 102 received <jats:styled-content style="fixed-case">ETN</jats:styled-content>, 62 <jats:styled-content style="fixed-case">ADA</jats:styled-content>, and 85 <jats:styled-content style="fixed-case">IFX</jats:styled-content>. In total, 103 discontinued treatment. The retention rates of <jats:styled-content style="fixed-case">IFX</jats:styled-content>,<jats:styled-content style="fixed-case"> ADA</jats:styled-content> and <jats:styled-content style="fixed-case">ETN</jats:styled-content> were 67%, 59% and 56% after 3 years; 62%, 42% and 47% after 5 years; 55%, 42% and 24% after 8 years; 53%, 42% and 12% after 10 years, respectively. In multivariate analyses, the predictive factors for retention were: low <jats:styled-content style="fixed-case">BASDAI</jats:styled-content> score (hazard ratio [<jats:styled-content style="fixed-case">HR</jats:styled-content>]: 1.02 [1.01‐1.04]), high C‐reactive protein levels (<jats:styled-content style="fixed-case">HR</jats:styled-content>: 0.98 [0.97‐0.99]), concomitant disease‐modifying therapy (<jats:styled-content style="fixed-case">HR</jats:styled-content>: 0.4 [0.21‐0.75]), and radiographic SpA (<jats:styled-content style="fixed-case">HR</jats:styled-content>: 1.5 [1.0‐2.52]). In total, 61 patients switched to another anti‐<jats:styled-content style="fixed-case">TNF</jats:styled-content> therapy. No difference was observed among the three anti‐<jats:styled-content style="fixed-case">TNF</jats:styled-content> therapies regarding median retention duration, although the retention rate proved higher for treatment switches from one monoclonal antibody to another.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The retention rate in SpA patients proved high, with retention for <jats:styled-content style="fixed-case">IFX</jats:styled-content> superior to that of <jats:styled-content style="fixed-case">ETN</jats:styled-content>.</jats:p></jats:sec>