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Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period

The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis w...

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Autores principales: Gomez-Reino, Juan J, Carmona, Loreto
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1526564/
https://www.ncbi.nlm.nih.gov/pubmed/16507128
http://dx.doi.org/10.1186/ar1881
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author Gomez-Reino, Juan J
Carmona, Loreto
author_facet Gomez-Reino, Juan J
Carmona, Loreto
author_sort Gomez-Reino, Juan J
collection PubMed
description The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34–0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97–2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13–4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications.
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spelling pubmed-15265642006-08-04 Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period Gomez-Reino, Juan J Carmona, Loreto Arthritis Res Ther Research Article The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34–0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97–2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13–4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications. BioMed Central 2006 2006-01-06 /pmc/articles/PMC1526564/ /pubmed/16507128 http://dx.doi.org/10.1186/ar1881 Text en Copyright © 2006 Gomez-Reino and Loreto Carmona; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Gomez-Reino, Juan J
Carmona, Loreto
Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period
title Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period
title_full Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period
title_fullStr Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period
title_full_unstemmed Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period
title_short Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period
title_sort switching tnf antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1526564/
https://www.ncbi.nlm.nih.gov/pubmed/16507128
http://dx.doi.org/10.1186/ar1881
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