title: Etanercept-Methotrexate Combination Therapy Initiators Have Greater Adherence and Persistence Than Triple Therapy Initiators With Rheumatoid Arthritis.
abstract: OBJECTIVE
  To estimate adherence and persistence with etanercept plus methotrexate (ETN-MTX) combination therapy and MTX, hydroxychloroquine, and sulfasalazine triple therapy at 1 year following treatment initiation in adults with rheumatoid arthritis (RA).
  
  
  METHODS
  This retrospective analysis used data from the Truven Health MarketScan Commercial and Medicare Supplemental databases from January 2009 to July 2013. Adherence was defined as having percentage of days covered >80% for all drugs within each regimen. Persistence was defined as no treatment gap >45 days for any drug and no addition or switching to other disease-modifying antirheumatic drugs. Multiple logistic regression models were employed in the analyses to control for potential confounders.
  
  
  RESULTS
  A total of 3,724 ETN-MTX patients and 818 triple therapy patients were eligible. At 1 year, 27.9% who were taking ETN-MTX and 18.2% using triple therapy were adherent to all agents in their regimen (P < 0.0001), and 29.4% who were taking ETN-MTX and 23.2% using triple therapy were persistent (P < 0.001). After adjusting for confounders, ETN-MTX patients had significantly greater odds of being adherent (odds ratio [OR] 1.79, 95% confidence interval [95% CI] 1.47-2.17) and persistent (OR 1.45, 95% CI 1.20-1.72) compared with patients using triple therapy.
  
  
  CONCLUSIONS
  Patients with RA initiating treatment with ETN-MTX combination therapy demonstrated greater adherence and persistence at 1 year than patients initiating triple therapy.
authors.affiliation: Truven Health Analytics, Cambridge, Massachusetts.
authors.forename: Machaon
authors.initials: M
authors.lastname: Bonafede
authors.affiliation: Truven Health Analytics, Cambridge, Massachusetts.
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Johnson
authors.affiliation: Amgen Inc., Thousand Oaks, California.
authors.forename: Derek H
authors.initials: DH
authors.lastname: Tang
authors.affiliation: Amgen Inc., Thousand Oaks, California.
authors.forename: Neel
authors.initials: N
authors.lastname: Shah
authors.affiliation: Amgen Inc., Thousand Oaks, California.
authors.forename: David J
authors.initials: DJ
authors.lastname: Harrison
authors.affiliation: Amgen Inc., Thousand Oaks, California.
authors.forename: David H
authors.initials: DH
authors.lastname: Collier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy*; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D000068800:Etanercept / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D016345:Medicare Part B; D055118:Medication Adherence; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012460:Sulfasalazine / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D012460:Sulfasalazine; D006886:Hydroxychloroquine; D000068800:Etanercept; D008727:Methotrexate