title: Retention on anti-tumour necrosis factor therapy: the Waikato experience.
abstract: OBJECTIVE
  To investigate the retention on anti-TNF agents used in a real-world setting, and determine the factors predicting retention on drug.
  
  
  METHODS
  Patients starting anti-TNF therapy were recorded prospectively on the departmental database. Medical records of all patients commenced on anti-TNF therapy between 2006 and 2013 at the Rheumatology Department, Waikato Hospital, Hamilton, were retrospectively reviewed to obtain details of their course on biologic therapy.
  
  
  RESULTS
  183 patients were identified. 139 (76.5%) were commenced on adalimumab. The predominant indication was rheumatoid arthritis (52.5%). 60 patients (32.8%) discontinued their initial anti-TNF agent. Of these, 31.7% were due to primary failure, 36.7% due to secondary failure and 25% due to adverse events. At 5 years, retention on agents was: adalimumab (77.2%), etanercept (69.6%) and infliximab (16.7%). Retention on adalimumab was significantly higher than infliximab (p<0.001), but did not differ between adalimumab and etanercept, or etanercept and infliximab.
  
  
  CONCLUSIONS
  In a real-world setting, retention on infliximab was significantly lower than adalimumab.
authors.forename: Ken
authors.initials: K
authors.lastname: Ip
authors.forename: Lorraine
authors.initials: L
authors.lastname: Hartley
authors.forename: Kamal
authors.initials: K
authors.lastname: Solanki
authors.affiliation: Rheumatology Department, Waikato Hospital, Pembroke Street, Private Bag 3200, Hamilton 3240, New Zealand. Douglas.White@waikatodhb.health.nz.
authors.forename: Douglas
authors.initials: D
authors.lastname: White
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002648:Child; D015331:Cohort Studies; D064420:Drug-Related Side Effects and Adverse Reactions; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D000069285:Infliximab; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D057240:Patient Preference; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000188:drug therapy*; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept