Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry
Por:
Prior-Espanol, A, Sanchez-Piedra, C, Campos, J, Manero, FJ, Perez-Garcia, C, Bohorquez, C, Busquets-Perez, N, Blanco-Madrigal, JM, Diaz-Torne, C, Sanchez-Alonso, F, Mateo, L, Holgado-Perez, S
Publicada:
27 may 2021
Resumen:
Biologic and targeted synthetic disease-modifying antirheumatic drugs (ts/bDMARDs) play a pivotal role in the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Persistence of therapy provides an index of a drug's overall effectiveness. The objective of the study was to identify factors associated with discontinuation of ts/bDMARDs in a real-world dataset. The study population comprised patients diagnosed with RA, PsA, and AS included in the BIOBADASER registry for whom follow-up data were available until November 2019. Patient features and treatment data were included in the analysis. The Kaplan-Meier method was used to study survival of the different drugs according to the reason for discontinuation. Factors associated with discontinuation were studied using Cox regression models and bivariate and multivariate analyses. P values of less than 0.05 were regarded as statistically significant. The study population comprised 4,752 patients who received a total of 8,377 drugs, of which 4,411 (52.65%) were discontinued. The Kaplan-Meier curves showed that survival for first-line treatment was greater in all 3 groups (p<0.001). Patients with RA had a greater risk of discontinuation if they were younger (HR, 0.99; 95% CI 0.99-1.00), if they were receiving anti-TNF agents (HR, 0.61; 95% CI 0.54-0.70), and if they had more comorbid conditions (HR, 1.09; 95% CI 1.00-1.17). Patients with PsA had a higher risk if they were women (HR, 1.36; 95% CI 1.15-1.62) and if they were receiving other ts/bDMARDs (HR, 1.29; 95% CI 1.05-1.59). In patients with AS, risk increased with age (HR, 1.01; 95% CI 1.00-1.02), as did the number of comorbid conditions (HR, 1.27; 95% CI 1.12-1.45). The factors that most affected discontinuation of ts/bDMARDs were line of treatment, age, type of drug, sex, comorbidity and the year of initiation of treatment. The association with these factors differed with each disease, except for first-line treatment, which was associated with a lower risk of discontinuation in all 3 diseases.
Filiaciones:
Prior-Espanol, A:
Hosp Badalona Germans Trias & Pujol, Rheumatol Unit, Carretera Canyet S-N, Barcelona 08916, Spain
Sanchez-Piedra, C:
Spanish Soc Rheumatol, Res Unit, Madrid, Spain
Campos, J:
Hosp Puerta de Hierro, Rheumatol Unit, Madrid, Spain
Manero, FJ:
Hosp Univ Miguel Servet, Rheumatol Unit, Zaragoza, Spain
Perez-Garcia, C:
Hosp del Mar, Rheumatol Unit, Barcelona, Spain
Bohorquez, C:
Hosp Univ Principe Asturias, Rheumatol Unit, Alcala De Henares, Spain
Busquets-Perez, N:
Hosp Gen Granollers, Rheumatol Unit, Barcelona, Spain
Blanco-Madrigal, JM:
Hosp Basurto, Rheumatol Unit, Vizcaya, Spain
Diaz-Torne, C:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Sanchez-Alonso, F:
Spanish Soc Rheumatol, Res Unit, Madrid, Spain
Mateo, L:
Hosp Badalona Germans Trias & Pujol, Rheumatol Unit, Carretera Canyet S-N, Barcelona 08916, Spain
Holgado-Perez, S:
Hosp Badalona Germans Trias & Pujol, Rheumatol Unit, Carretera Canyet S-N, Barcelona 08916, Spain
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