Abstract
Objectives. We investigated factors associated with discontinuation of anti-tumor necrosis factor (TNF) therapy in patients with ankylosing spondylitis (AS), who were anti-TNF-naïve and were given etanercept (ETN) or adalimumab (ADA). Methods. This is a retrospective nationwide population-based cohort study. We identified 1401 anti-TNF-naïve patients with AS who initiated ETN (n = 441) or ADA (n = 960) and measured the duration of anti-TNF drug use. We recorded demographic and clinical data of all patients, and calculated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazard regression analyses. Results. Overall, the ADA and ETN groups had similar risk for drug discontinuation (HR: 0.83; 95% CI: 0.63-1.08). In each group, concomitant use of methotrexate (MTX) or a non-steroidal anti-inflammatory drug was associated with a lower risk of discontinuation. Subgroup analysis indicated that concomitant MTX use reduced risk of discontinuation of ADA (HR: 0.54; 95% CI: 0.40-0.74), but not ETN (HR: 1.03; 95% CI: 0.65-1.63). Conclusions. This study of anti-TNF-naïve patients with AS indicated that users of ADA and ETN had similar overall risk of drug discontinuation. However, patients taking ADA with MTX had a lower risk of discontinuation than those taking ADA alone.
| Original language | English |
|---|---|
| Pages (from-to) | 903-907 |
| Number of pages | 5 |
| Journal | Modern Rheumatology |
| Volume | 25 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Sep 8 2015 |
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Keywords
- Adalimumab
- Ankylosing spondylitis
- Etanercept
- Methotrexate
- Treatment discontinuation
- Tumor necrosis factor-α
ASJC Scopus subject areas
- Rheumatology
Cite this
Factors affecting discontinuation of adalimumab and etanercept therapy in anti-TNF-naïve patients with ankylosing spondylitis : Nationwide population-based cohort study. / Chen, Hsin Hua; Chen, Yi Ming; Lai, Kuo Lung; Lin, Ching Heng; Tang, Chao Hsiung; Chen, Der Yuan.
In: Modern Rheumatology, Vol. 25, No. 6, 08.09.2015, p. 903-907.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Factors affecting discontinuation of adalimumab and etanercept therapy in anti-TNF-naïve patients with ankylosing spondylitis
T2 - Nationwide population-based cohort study
AU - Chen, Hsin Hua
AU - Chen, Yi Ming
AU - Lai, Kuo Lung
AU - Lin, Ching Heng
AU - Tang, Chao Hsiung
AU - Chen, Der Yuan
PY - 2015/9/8
Y1 - 2015/9/8
N2 - Objectives. We investigated factors associated with discontinuation of anti-tumor necrosis factor (TNF) therapy in patients with ankylosing spondylitis (AS), who were anti-TNF-naïve and were given etanercept (ETN) or adalimumab (ADA). Methods. This is a retrospective nationwide population-based cohort study. We identified 1401 anti-TNF-naïve patients with AS who initiated ETN (n = 441) or ADA (n = 960) and measured the duration of anti-TNF drug use. We recorded demographic and clinical data of all patients, and calculated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazard regression analyses. Results. Overall, the ADA and ETN groups had similar risk for drug discontinuation (HR: 0.83; 95% CI: 0.63-1.08). In each group, concomitant use of methotrexate (MTX) or a non-steroidal anti-inflammatory drug was associated with a lower risk of discontinuation. Subgroup analysis indicated that concomitant MTX use reduced risk of discontinuation of ADA (HR: 0.54; 95% CI: 0.40-0.74), but not ETN (HR: 1.03; 95% CI: 0.65-1.63). Conclusions. This study of anti-TNF-naïve patients with AS indicated that users of ADA and ETN had similar overall risk of drug discontinuation. However, patients taking ADA with MTX had a lower risk of discontinuation than those taking ADA alone.
AB - Objectives. We investigated factors associated with discontinuation of anti-tumor necrosis factor (TNF) therapy in patients with ankylosing spondylitis (AS), who were anti-TNF-naïve and were given etanercept (ETN) or adalimumab (ADA). Methods. This is a retrospective nationwide population-based cohort study. We identified 1401 anti-TNF-naïve patients with AS who initiated ETN (n = 441) or ADA (n = 960) and measured the duration of anti-TNF drug use. We recorded demographic and clinical data of all patients, and calculated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazard regression analyses. Results. Overall, the ADA and ETN groups had similar risk for drug discontinuation (HR: 0.83; 95% CI: 0.63-1.08). In each group, concomitant use of methotrexate (MTX) or a non-steroidal anti-inflammatory drug was associated with a lower risk of discontinuation. Subgroup analysis indicated that concomitant MTX use reduced risk of discontinuation of ADA (HR: 0.54; 95% CI: 0.40-0.74), but not ETN (HR: 1.03; 95% CI: 0.65-1.63). Conclusions. This study of anti-TNF-naïve patients with AS indicated that users of ADA and ETN had similar overall risk of drug discontinuation. However, patients taking ADA with MTX had a lower risk of discontinuation than those taking ADA alone.
KW - Adalimumab
KW - Ankylosing spondylitis
KW - Etanercept
KW - Methotrexate
KW - Treatment discontinuation
KW - Tumor necrosis factor-α
UR - http://www.scopus.com/inward/record.url?scp=84947022906&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84947022906&partnerID=8YFLogxK
U2 - 10.3109/14397595.2015.1038426
DO - 10.3109/14397595.2015.1038426
M3 - Article
AN - SCOPUS:84947022906
VL - 25
SP - 903
EP - 907
JO - Modern Rheumatology
JF - Modern Rheumatology
SN - 1439-7595
IS - 6
ER -