Bibliographic Details
| Title: |
Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study |
| Authors: |
Motomu Hashimoto, Wataru Yamamoto, Atsushi Kumanogoh, Yuichi Maeda, Yasutaka Okita, Ken Nakata, Shinya Hayashi, Masaki Katayama, Tadashi Okano, Takayuki Fujii, Seiji Okada, Kosuke Ebina, Yuki Etani, Makoto Hirao, Koichi Murata, Ryota Hara, Koji Nagai, Yuri Hiramatsu, Yonsu Son, Hideki Amuro, Takaichi Okano, Yo Ueda, Shotaro Tachibana |
| Source: |
RMD Open, Vol 9, Iss 3 (2023) |
| Publisher Information: |
BMJ Publishing Group, 2023. |
| Publication Year: |
2023 |
| Collection: |
LCC:Medicine |
| Subject Terms: |
Medicine |
| More Details: |
Objectives This multicentre retrospective study in Japan aimed to assess the retention of biological disease-modifying antirheumatic drugs and Janus kinase inhibitors (JAKi), and to clarify the factors affecting their retention in a real-world cohort of patients with rheumatoid arthritis.Methods The study included 6666 treatment courses (bDMARD-naïve or JAKi-naïve cases, 55.4%; tumour necrosis factor inhibitors (TNFi) = 3577; anti-interleukin-6 receptor antibodies (aIL-6R) = 1497; cytotoxic T lymphocyte-associated antigen-4-Ig (CTLA4-Ig) = 1139; JAKi=453 cases). The reasons for discontinuation were divided into four categories (ineffectiveness, toxic adverse events, non-toxic reasons and remission); multivariate Cox proportional hazards modelling by potential confounders was used to analyse the HRs of treatment discontinuation.Results TNFi (HR=1.93, 95% CI: 1.69 to 2.19), CTLA4-Ig (HR=1.42, 95% CI: 1.20 to 1.67) and JAKi (HR=1.29, 95% CI: 1.03 to 1.63) showed a higher discontinuation rate due to ineffectiveness than aIL-6R. TNFi (HR=1.28, 95% CI: 1.05 to 1.56) and aIL-6R (HR=1.27, 95% CI: 1.03 to 1.57) showed a higher discontinuation rate due to toxic adverse events than CTLA4-Ig. Concomitant use of oral glucocorticoids (GCs) at baseline was associated with higher discontinuation rate due to ineffectiveness in TNFi (HR=1.24, 95% CI: 1.09 to 1.41), as well as toxic adverse events in JAKi (HR=2.30, 95% CI: 1.23 to 4.28) and TNFi (HR=1.29, 95%CI: 1.07 to 1.55).Conclusions TNFi (HR=1.52, 95% CI: 1.37 to 1.68) and CTLA4-Ig (HR=1.14, 95% CI: 1.00 to 1.30) showed a higher overall drug discontinuation rate, excluding non-toxicity and remission, than aIL-6R. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2056-5933 |
| Relation: |
https://rmdopen.bmj.com/content/9/3/e003160.full; https://doaj.org/toc/2056-5933 |
| DOI: |
10.1136/rmdopen-2023-003160 |
| Access URL: |
https://doaj.org/article/c7789ed324f64b73b06d2a49de139a14 |
| Accession Number: |
edsdoj.7789ed324f64b73b06d2a49de139a14 |
| Database: |
Directory of Open Access Journals |
