The comparative one-year performance of anti–tumor necrosis factor α drugs in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: Results from a longitudinal, observational, multicenter study

Authors

  • Marte Schrumpf Heiberg,

    Corresponding author
    1. Diakonhjemmet Hospital, Oslo, Norway
    • Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, 0319 Oslo, Norway
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    • Dr. Heiberg has received speaking fees and honoraria (less than $10,000) from Abbott and consultancy fees (less than $10,000) from Wyeth. Dr. Koldingsnes has received speaking fees (less than $10,000 each) from Schering-Plough, Wyeth, and Abbott. Dr. Mikkelsen has received honoraria (less than $10,000 each) from Roche and Bristol-Myers Squibb. Dr. Kvien has received consultancies and speaking fees (less than $10,000 each) from Abbott, Schering-Plough, and Wyeth.

  • Wenche Koldingsnes,

    1. University Hospital Northern Norway, Tromsø, Norway
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    • Dr. Heiberg has received speaking fees and honoraria (less than $10,000) from Abbott and consultancy fees (less than $10,000) from Wyeth. Dr. Koldingsnes has received speaking fees (less than $10,000 each) from Schering-Plough, Wyeth, and Abbott. Dr. Mikkelsen has received honoraria (less than $10,000 each) from Roche and Bristol-Myers Squibb. Dr. Kvien has received consultancies and speaking fees (less than $10,000 each) from Abbott, Schering-Plough, and Wyeth.

  • Knut Mikkelsen,

    1. Lillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway
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    • Dr. Heiberg has received speaking fees and honoraria (less than $10,000) from Abbott and consultancy fees (less than $10,000) from Wyeth. Dr. Koldingsnes has received speaking fees (less than $10,000 each) from Schering-Plough, Wyeth, and Abbott. Dr. Mikkelsen has received honoraria (less than $10,000 each) from Roche and Bristol-Myers Squibb. Dr. Kvien has received consultancies and speaking fees (less than $10,000 each) from Abbott, Schering-Plough, and Wyeth.

  • Erik Rødevand,

    1. St. Olav Hospital, Trondheim, Norway
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  • Cecilie Kaufmann,

    1. Buskerud Central Hospital, Drammen, Norway
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  • Petter Mowinckel,

    1. Diakonhjemmet Hospital, Oslo, Norway
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  • Tore K. Kvien

    1. Diakonhjemmet Hospital, Oslo, Norway
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    • Dr. Heiberg has received speaking fees and honoraria (less than $10,000) from Abbott and consultancy fees (less than $10,000) from Wyeth. Dr. Koldingsnes has received speaking fees (less than $10,000 each) from Schering-Plough, Wyeth, and Abbott. Dr. Mikkelsen has received honoraria (less than $10,000 each) from Roche and Bristol-Myers Squibb. Dr. Kvien has received consultancies and speaking fees (less than $10,000 each) from Abbott, Schering-Plough, and Wyeth.


Abstract

Objective

To compare the 1-year retention rates of anti–tumor necrosis factor α (anti-TNFα) medications in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) with complementary analyses of the effect on health status.

Methods

Our analyses comprised 847, 172, and 249 anti-TNFα treatment courses in patients with RA, PsA, and AS, respectively. Crude drug survival was compared and hazard ratios (HRs) for treatment termination were calculated with adjustments for age, sex, investigator's global assessment, and concomitant methotrexate (MTX). Adjusted changes in health-related quality of life (HRQOL) were compared among the groups.

Results

Unadjusted 1-year retention rates were 65.4%, 77.3%, and 77.5% in the RA, PsA, and AS groups, respectively. The adjusted HRs for treatment termination were 0.76 (95% confidence interval [95% CI] 0.53–1.07) for PsA versus RA and 0.66 (95% CI 0.47–0.92) for AS versus RA. High baseline disease activity and female sex were significantly associated with premature treatment termination, whereas concomitant MTX was associated with better drug survival. However, the impact of MTX was apparent for RA and PsA, but not for AS in stratified analyses. The improvements in HRQOL were superior in patients with PsA and AS compared with RA.

Conclusion

Our results suggest that survival of anti-TNFα treatment is superior in AS and PsA patients compared with RA patients. Larger improvements in HRQOL in patients with spondylarthritides may contribute to the differences in drug survival. Concomitant MTX was associated with better retention rates in RA and PsA patients, but not AS patients.

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