@article {Emeryjrheum.181398, author = {Paul Emery and Bonnie Vlahos and Piotr Szczypa and Mazhar Thakur and Heather E. Jones and John Woolcott and Paul V. Santos Estrella and Catherine Rolland and Allan Gibofsky and Gustavo Citera and Sargunan Sockalingam and Lisa Marshall}, title = {Long-term drug survival of tumor necrosis factor inhibitors in patients with rheumatoid arthritis}, elocation-id = {jrheum.181398}, year = {2019}, doi = {10.3899/jrheum.181398}, publisher = {The Journal of Rheumatology}, abstract = {Objective Evaluate long-term drug survival (proportion of patients still receiving treatment) and discontinuation of etanercept, infliximab, adalimumab, certolizumab pegol, and golimumab using observational data from patients with rheumatoid arthritis. Methods Following a systematic literature review, drug survival at 12 and 12{\textendash}24 months of follow-up was estimated by summing proportions of patients remaining on treatment and dividing by number of studies. Drug survival at >=36 months of follow-up was estimated via Metaprop. Results 170 publications were included. In the first-line setting, drug survival at 12 months with etanercept, infliximab, or adalimumab was 71\%, 69\%, and 70\%, respectively, while at 12{\textendash}24 months the corresponding rates were 63\%, 57\%, and 59\%. In the second-line setting, drug survival at 12 months with etanercept, infliximab, or adalimumab was 61\%, 69\%, and 55\%, respectively, while at 12{\textendash}24 months the corresponding rates were 53\%, 39\%, and 43\%. Drug survival at >=36 months with etanercept, infliximab, or adalimumab in the first-line setting was 59\% (95\% confidence interval [CI]: 46{\textendash}72\%), 49\% (95\% CI: 43{\textendash}54\%), and 51\% (95\% CI: 41{\textendash}60\%), respectively, while in the second-line setting the corresponding rates were 56\% (95\% CI: 52{\textendash}61\%), 48\% (95\% CI: 40{\textendash}55\%), and 41\% (95\% CI: 36{\textendash}47\%). Discontinuation of etanercept, infliximab, and adalimumab at 36 months of follow-up was 38{\textendash}48\%, 42{\textendash} 62\%, and 38{\textendash}59\%, respectively. Data on certolizumab pegol and golimumab were scarce. Conclusion After \>12 months of follow-up, more patients with rheumatoid arthritis receiving etanercept remain on treatment compared with other TNFi.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/early/2019/05/24/jrheum.181398}, eprint = {https://www.jrheum.org/content/early/2019/05/24/jrheum.181398.full.pdf}, journal = {The Journal of Rheumatology} }