Retention Rate of Tumor Necrosis Factor Alpha Inhibitors
Background: In routine practice, observational registries may show retention rates of tumor necrosis factor inhibitor (TNFi) drugs in rheumatoid arthritis (RA). The objective of this study was to compare TNFi regarding the drug survival rate in RA patients.
Methods: HUR-BIO (Hacettepe University Rheumatology Biologic Registry) is a single center biological registry since 2005. Data collected includes demographic data, switch ratio, baseline and follow-up disease activity parameters (if available). Patients with lost of follow-up searched regarding to last TNFi prescription date either local computer system or national social security institution database. Beginning and last date of TNFi were noted from those systems. First TNFi drug switch date (either adverse event or inefficacy) was accepted as main variable for drug survival. Kaplan-Meier plots and log rank tests were used to assess drug survival.
Results: HUR-BIO includes 653 patients 77.9% was female. Mean age was 50±13 years and mean disease duration was 10.5±8.2 years. First TNFi drugs were etanercept 318 (48.7%), adalimumab 219 (33.5%) and infliximab 116 (17.8%). Patients were divided as regularly follow-up (either first biological drugs or another biological drugs) 455 (69.7%), lost of follow-up 144 (22.1%), drug cessation 36 (5.5%), exitus 18 (2.7%) Patients with etanercept had better drug retention than monoclonal antibodies (log rank p=0.014).
Conclusion: In this single center observational registry, etanercept had better drug retention rate than monoclonal antibodies. On the other hand, certain confounder factors such as baseline disease activity, functional status, and socioeconomic status were not known in whole patients, thus our results should evaluate in this limitation.
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