title: Retention of tocilizumab and anti-tumour necrosis factor drugs in the treatment of rheumatoid arthritis.
abstract: OBJECTIVE
  The retention of the anti-rheumatic agent tocilizumab (TCZ) has not been well documented in patients with rheumatoid arthritis (RA). We conducted an observational study to compare the retention of TCZ and anti-tumour necrosis factor (TNF) drugs in the treatment of patients with RA.
  
  
  METHODS
  We reviewed continuation rates and causes of discontinuation of biological agents (biologics) by assessing medical records of patients with RA who were administered biologics at our institute from September 1999 to April 2012, using the Osaka University Biologics for Rheumatic Diseases (BiRD) registry.
  
  
  RESULTS
  A total of 401 patients were included. TCZ, infliximab (IFX), etanercept (ETN), and adalimumab (ADA) were administered to 97, 103, 143, and 58 patients, respectively. There were some differences between the baseline characteristics of the groups. The median duration (range) of TCZ, IFX, ETN, and ADA administration was 2.5 (0.1-12.6), 1.9 (0.0-7.7), 2.9 (0.0-11.3), and 1.3 (0.0-3.4) years, respectively. Continuation rates for TCZ and ETN were significantly higher than those for IFX and ADA. Multivariate analyses showed that discontinuation due to lack or loss of efficacy was significantly less common in the TCZ group than in the other groups. Discontinuation due to overall adverse events was not significantly different between treatment groups.
  
  
  CONCLUSIONS
  TCZ and ETN show better retention than IFX or ADA in the treatment of RA.
authors.affiliation: Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hishitani
authors.forename: A
authors.initials: A
authors.lastname: Ogata
authors.forename: Y
authors.initials: Y
authors.lastname: Shima
authors.forename: T
authors.initials: T
authors.lastname: Hirano
authors.forename: K
authors.initials: K
authors.lastname: Ebina
authors.forename: Y
authors.initials: Y
authors.lastname: Kunugiza
authors.forename: K
authors.initials: K
authors.lastname: Shi
authors.forename: M
authors.initials: M
authors.lastname: Narazaki
authors.forename: K
authors.initials: K
authors.lastname: Hagihara
authors.forename: T
authors.initials: T
authors.lastname: Tomita
authors.forename: H
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: T
authors.initials: T
authors.lastname: Tanaka
authors.forename: A
authors.initials: A
authors.lastname: Kumanogoh
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000493:pharmacokinetics*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; C502936:tocilizumab