PT  - JOURNAL ARTICLE
AU  - IANNONE, FLORENZO
AU  - GREMESE, ELISA
AU  - ATZENI, FABIOLA
AU  - BIASI, DOMENICO
AU  - BOTSIOS, COSTANTINO
AU  - CIPRIANI, PAOLA
AU  - FERRI, CLODOVEO
AU  - FOSCHI, VALENTINA
AU  - GALEAZZI, MAURO
AU  - GERLI, ROBERTO
AU  - GIARDINA, ANNARITA
AU  - MARCHESONI, ANTONIO
AU  - SALAFFI, FAUSTO
AU  - ZIGLIOLI, TAMARA
AU  - LAPADULA, GIOVANNI
AU  - Gruppo Italiano di Studio sulle Early Arthritides (GISEA)
TI  - Longterm Retention of Tumor Necrosis Factor-α Inhibitor Therapy in a Large Italian Cohort of Patients with Rheumatoid Arthritis from the GISEA Registry: An Appraisal of Predictors
AID  - 10.3899/jrheum.111125
DP  - 2012 Jun 01
TA  - The Journal of Rheumatology
PG  - 1179--1184
VI  - 39
IP  - 6
4099  - http://www.jrheum.org/content/39/6/1179.short
4100  - http://www.jrheum.org/content/39/6/1179.full
SO  - J Rheumatol2012 Jun 01; 39
AB  - Objective. To evaluate 4-year retention rates of tumor necrosis factor-α (TNF-α) inhibitors adalimumab, etanercept, and infliximab among patients with longstanding rheumatoid arthritis (RA), as derived from an Italian national registry. Methods. The clinical records of 853 adult patients with RA in the GISEA (Gruppo Italiano Studio Early Arthritis) registry were prospectively analyzed to compare drug survival rates and the baseline factors that may predict adherence to therapy. Results. In 2003 and 2004, 324 patients started treatment with adalimumab, 311 with etanercept, and 218 with infliximab. After 4 years, the global retention rate of anti-TNF-α therapy was 42%. Etanercept survival (51.4%) was significantly better than that of infliximab (37.6%) or adalimumab (36.4%; p < 0.0001). Accordingly, the mean duration of therapy was significantly longer for etanercept (3.1 ± 2 yrs) than for adalimumab (2.6 ± 2 yrs) or infliximab (2.7 ± 2 yrs; p < 0.05). The use of concomitant disease-modifying antirheumatic drugs, mainly methotrexate, and the presence of comorbidities significantly predicted drug continuation (p < 0.01), whereas a high Disease Activity Score did not. Conclusion. The 4-year global drug survival of adalimumab, etanercept, and infliximab was lower than 50%, with etanercept having the best retention rate. The main positive predictor of adherence to anti-TNF-α therapy was the concomitant use of methotrexate. Our study provides further evidence that the real-life treatment of patients with RA may be different from that of randomized clinical trials.