Journal
RHEUMATOLOGY
Volume 50, Issue 1, Pages 204-213Publisher
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/keq326
Keywords
Biologics; Rheumatoid arthritis; Anti-tumour necrosis factor; Psoriatic arthritis; Spondylarthritides
Categories
Funding
- Swedish Association of Local Authorities and Regions
- Schering-Plough
- Bristol-Myers Squibb
- Wyeth
- Abbott Laboratories
- Roche
- Abbott
- Merck
- UCB Pharma
- Pfizer
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Methods. We identified all adult patients with RA (n = 9612), PsA (n = 1417) and other SpA (n = 1652) initiating a first biologic therapy between 1 January 1999 and 31 December 2008, registered in the Swedish Biologics Register (ARTIS), including information on demographics, disease characteristics and 1-year risk of first-line treatment discontinuation. Results. Over calendar time, measures of disease activity at start declined substantially for all indications, and diminished between first-, second- and third-line therapy starts. One-year risks of first-line therapy discontinuation increased. Switchers to anti-TNF and non-TNF biologics had different comorbidities. Despite < 50% drug retention at 5 years, most patients remained exposed to some biologic. Conclusions. The trends in baseline characteristics and drug retention underscores that any effects of biologics, including comparison between different biologics, must be interpreted in light of the characteristics of the population treated. The observed differences further call for continued vigilance to properly evaluate the safety profiles of biologic treatments as they are currently used. Exposure to multiple biologics presents a challenge for attribution of long-term effects.
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