title: Five-year survival on infliximab in rheumatoid arthritis patients: analysis from an Italian registry (GISEA) by different calendar years.
abstract: OBJECTIVE
  To assess long-term drug survival and effectiveness in biological drug-naïve patients with rheumatoid arthritis (RA), starting infliximab as first treatment, in the period 2000-2009, comparing different calendar years.
  
  
  METHODS
  Patients with RA recorded in the GISEA registry beginning infliximab as first ever biological drug were enrolled, subdivided into periods 2000-2002, 2003-2005, and 2006-2009. We evaluated 5-year drug survival by Kaplan-Meier life analysis and 1-year EULAR responses based on the 28 joint count Disease Activity Score (DAS28), and baseline predictors, by multiple logistic regression analysis.
  
  
  RESULTS
  Of 565 RA patients included in the analysis, 290 (51.3%) began infliximab in years 2000-2002, 167 (29.5%) in 2003-2005, and 108 (19.1%) in 2006-2009. At entry, DAS28-ESR was significantly lower in 2006-2009 (5.1 ± 1.3) than in 2000-2002 (6.0 ± 1.2) or 2003-2006 (6.0 ± 1.0) (p=0.001). Significantly more RA patients attained a EULAR "good" response at 1 year in 2006-2009 (39.8%) than in 2000-2002 (23.1%, p=0.001). Nevertheless, the rate of drug survival at 5 years, roughly 40%, was not significantly different over the calendar periods. Co-administration of DMARDs was significantly correlated with drug survival (Odds Ratio (OR) 1.42, 95% Confidence Intervals (CI) 1.005-2.09, p=0.04), but not the period when starting treatment. Instead, a EULAR "good" response was significantly correlated with the period 2006-2009 (OR 2.24, 95% CI 1.37-3.65, p=0.02).
  
  
  CONCLUSIONS
  Our study shows that RA patients have similar drug survival on infliximab regardless of the period when they started. However, patients treated in more recent years tend to have less active RA and to more readily attain favourable clinical outcomes.
authors.affiliation: Rheumatology Unit, University of Bari, Italy.
authors.forename: Florenzo
authors.initials: F
authors.lastname: Iannone
authors.affiliation: Rheumatology Unit, Università Politecnica delle Marche, Jesi, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Salaffi
authors.affiliation: Rheumatology Unit, Ospedale G. Pini, Milano, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Marchesoni
authors.affiliation: Rheumatology Unit, University of Brescia, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gorla
authors.affiliation: Rheumatology Unit, Ospedale Luigi Sacco, Milano, Italy.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Atzeni
authors.affiliation: Rheumatology Unit, University of Ferrara, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Govoni
authors.affiliation: Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Gremese
authors.affiliation: Rheumatology Unit, University of Bari, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lapadula
authors.affiliation: GISEA (Gruppo Italiano di Studio sulle Early Arthritides).
authors.forename: A
authors.initials: A
authors.lastname: On Behalf Of Gisea Gruppo Italiano di Studio Sulle Early Arthritides
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D018771:Arthralgia / Q000175:diagnosis*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D003710:Demography; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D000069285:Infliximab; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D062072:Patient Acuity; D063868:Patient Outcome Assessment; D012042:Registries; D012074:Remission Induction / Q000379:methods; D012217:Rheumatoid Factor / Q000097:blood; D061665:Time-to-Treatment
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D002097:C-Reactive Protein; D012217:Rheumatoid Factor; D000069285:Infliximab