title: Adherence to biologic DMARD therapies in rheumatoid arthritis.
abstract: BACKGROUND
  The efficacy of the biologic disease-modifying antirheumatic drugs (DMARDs) shown in clinical trials may be jeopardized due to prevalent poor patient adherence.
  
  
  METHODS
  Patient adherence including compliance and persistence with biologic DMARDs in rheumatoid arthritis.
  
  
  RESULTS
  This is a comprehensive review of the literature. The various definitions and methodologies of measurement used in adherence research are reviewed and data are presented by separating compliance and persistence. Differences in compliance rates were mainly based on numerical trends. There was evidence for and against greater persistence with infliximab versus adalimumab and etanercept. There was a trend in favour of greater compliance and lower persistence with TNF-alpha inhibitor monotherapy versus in combination therapy with methotrexate.
  
  
  CONCLUSIONS
  The evidence suggests that adherence to biologic DMARDs is suboptimal. When further research is applied in the field, agreed definitions and methodology need to be used to allow for cross-study comparisons. In addition, adherence should be assessed in conjunction with clinical outcomes and not on its own so that it can be better understood what levels of adherence provide the required clinical outcomes.
authors.affiliation: Semmelweis University, Budapest, Hungary. koncztoma@yahoo.com
authors.forename: Tamas
authors.initials: T
authors.lastname: Koncz
authors.forename: Marta
authors.initials: M
authors.lastname: Pentek
authors.forename: Valentin
authors.initials: V
authors.lastname: Brodszky
authors.forename: Katalin
authors.initials: K
authors.lastname: Ersek
authors.forename: Ewa
authors.initials: E
authors.lastname: Orlewska
authors.forename: Laszlo
authors.initials: L
authors.lastname: Gulacsi
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use*; D006801:Humans; D055118:Medication Adherence
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products