RT Journal Article
SR Electronic
T1 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
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1179
OP 1184
DO 10.3899/jrheum.111125
VO 39
IS 6
A1 FLORENZO IANNONE
A1 ELISA GREMESE
A1 FABIOLA ATZENI
A1 DOMENICO BIASI
A1 COSTANTINO BOTSIOS
A1 PAOLA CIPRIANI
A1 CLODOVEO FERRI
A1 VALENTINA FOSCHI
A1 MAURO GALEAZZI
A1 ROBERTO GERLI
A1 ANNARITA GIARDINA
A1 ANTONIO MARCHESONI
A1 FAUSTO SALAFFI
A1 TAMARA ZIGLIOLI
A1 GIOVANNI LAPADULA
A1 Gruppo Italiano di Studio sulle Early Arthritides (GISEA)
YR 2012
UL http://www.jrheum.org/content/39/6/1179.abstract
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.