Journal
ANNALS OF THE RHEUMATIC DISEASES
Volume 71, Issue 11, Pages 1820-1826Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/annrheumdis-2011-200838
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Funding
- Ministry of Health, Labour and Welfare, Japan [H23-meneki-sitei-016, H19-meneki-ippan-009, H22-meneki-ippann-001]
- Japan Society for the Promotion of Science [20390158, 19590530, 50277141]
- Abbott Laboratories
- Bristol-Myers Japan
- Eisai
- Chugai Pharmaceutical
- Mitsubishi Tanabe Pharma Corp
- Takeda Pharmaceutical
- Pfizer Japan
- Japanese Ministry of Education, Global Center of Excellence (GCOE) Program, 'International Research Center for Molecular Science in Tooth and Bone Diseases'
- Mitsubishi Tanabe Pharma
- Astellas Pharma
- Abbott Japan
- MSD KK
- Bristol-Myers Squibb KK
- Daiichi Sankyo
- Janssen Pharmaceutical KK
- Teijin Pharma
- Santen Pharmaceutical
- Grants-in-Aid for Scientific Research [22591074, 22390198, 19590530, 20390158, 23406031] Funding Source: KAKEN
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Objective To compare reasons for discontinuation and drug retention rates per reason among anticytokine therapies, infliximab, etanercept and tocilizumab, and the risk of discontinuation of biological agents due to adverse events (AE) in patients with rheumatoid arthritis (RA). Method This prospective cohort study included Japanese RA patients who started infliximab (n = 412, 636.0 patient-years (PY)), etanercept (n = 442, 765.3 PY), or tocilizumab (n = 168, 206.5 PY) as the first biological therapy after their enrolment in the Registry of Japanese Rheumatoid Arthritis Patients for Long-term Safety (REAL) database. Drug retention rates were calculated using the Kaplan-Meier method. To compare risks of drug discontinuation due to AE for patients treated with these biological agents, the Cox proportional hazard model was applied. Results The authors found significant differences among the three therapeutic groups in demography, clinical status, comorbidities and usage of concomitant drugs. Development of AE was the most frequent reason for discontinuation of biological agents in the etanercept and tocilizumab groups, and the second most frequent reason in the infliximab group. Discontinuation due to good control was observed most frequently in the infliximab group. Compared with etanercept, the use of infliximab (HR 1.69; 95% CI 1.14 to 2.51) and tocilizumab (HR 1.98; 95% CI 1.04 to 3.76) was significantly associated with a higher risk of discontinuation of biological agents due to AE. Conclusions Reasons for discontinuation are significantly different among biological agents. The use of infliximab and tocilizumab was significantly associated with treatment discontinuation due to AE compared with etanercept.
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