title: Drug survival rates of tumor necrosis factor inhibitors in patients with rheumatoid arthritis and ankylosing spondylitis.
abstract: We investigated the compliance of Korean patients using tumor necrosis factor (TNF) inhibitors to treat rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and identified potential predictors associated with treatment discontinuation. The study population comprised 114 RA and 310 AS patients treated with TNF inhibitors at a single tertiary center for at least 1 yr from December 2002 to November 2011. Of the 114 RA patients, 64 (56.1%) discontinued their first TNF inhibitors with a mean duration of 18.1 months. By contrast, 65 of 310 patients (21.0%) with AS discontinued their first TNF inhibitors, with a mean duration of 84 months. Although the survival rate did not differ among the three TNF inhibitors in the AS patients, the etanercept group had a lower discontinuation rate than the infliximab group in the RA patients. In addition, RA patients who received corticosteroids in combination with TNF inhibitors were more likely to discontinue their TNF inhibitors. The independent predictors of drug discontinuation in AS patients were male gender and complete ankylosis on radiographs of the sacroiliac joint. Our results provide further evidence that real-life treatment outcomes of RA and AS patients may be different from those observed in randomized clinical trials.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea.
authors.forename: Ji-Hyoun
authors.identifier: 0000-0003-1113-2001
authors.initials: JH
authors.lastname: Kang
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea.
authors.forename: Dong-Jin
authors.identifier: 0000-0002-8709-987X
authors.initials: DJ
authors.lastname: Park
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea.
authors.forename: Jeong-Won
authors.identifier: 0000-0002-6945-0398
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea.
authors.forename: Kyung-Eun
authors.identifier: 0000-0003-1048-9068
authors.initials: KE
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea.
authors.forename: Lihui
authors.identifier: 0000-0002-6385-0825
authors.initials: L
authors.lastname: Wen
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea.
authors.forename: Tae-Jong
authors.identifier: 0000-0002-6749-7598
authors.initials: TJ
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea.
authors.forename: Yong-Wook
authors.identifier: 0000-0002-6937-7119
authors.initials: YW
authors.lastname: Park
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea.
authors.forename: Shin-Seok
authors.identifier: 0000-0001-6810-7355
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000401:mortality; D015331:Cohort Studies; D000068800:Etanercept; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011859:Radiography; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012737:Sex Factors; D013167:Spondylitis, Ankylosing / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D062606:Tertiary Care Centers; D016312:Treatment Refusal; D000079424:Tumor Necrosis Factor Inhibitors; D048069:Tumor Necrosis Factors / Q000378:metabolism
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000079424:Tumor Necrosis Factor Inhibitors; D048069:Tumor Necrosis Factors; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
keywords: Arthritis, Rheumatoid; Spondylitis, Ankylosing; Survival; TNF Inhibitor