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Title: Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis -The ANSWER cohort study-
Authors: Ebina, Kosuke
Hashimoto, Motomu  kyouindb  KAKEN_id
Yamamoto, Wataru
Hirano, Toru
Hara, Ryota
Katayama, Masaki
Onishi, Akira  kyouindb  KAKEN_id
Nagai, Koji
Son, Yonsu
Amuro, Hideki
Yamamoto, Keiichi
Maeda, Yuichi
Murata, Koichi  kyouindb  KAKEN_id
Jinno, Sadao
Takeuchi, Tohru
Hirao, Makoto
Kumanogoh, Atsushi
Yoshikawa, Hideki
Author's alias: 蛯名, 耕介
橋本, 求
山本, 渉
平野, 亨
原, 良太
片山, 昌紀
大西, 輝
永井, 孝治
孫, 瑛洙
安室, 秀樹
山本, 景一
前田, 悠一
村田, 浩一
神野, 定男
武内, 徹
平尾, 眞
熊ノ郷, 淳
吉川, 秀樹
Issue Date: 8-May-2019
Publisher: Public Library of Science (PLoS)
Journal title: PLOS ONE
Volume: 14
Issue: 5
Thesis number: e0216624
Abstract: Background: The aim of this study is to evaluate the retention rates and reasons for discontinuation for seven biological disease-modifying antirheumatic drugs (bDMARDs) in a real-world setting of elderly patients (65 years of age or older) with rheumatoid arthritis (RA). Methods: This multi-center, retrospective study assessed 1, 098 treatment courses of 661 patients with bDMARDs from 2009 to 2018 (females, 80.7%; baseline age, 71.7 years; disease duration 10.5 years; rheumatoid factor positivity 81.3%; Disease Activity Score in 28 joints using erythrocyte sedimentation rate, 4.6; concomitant prednisolone dose 2.8 mg/day (45.6%) and methotrexate dose 4.4 mg/week (56.4%); and 60.2% patients were bio-naïve). Treatment courses included abatacept (ABT; n = 272), tocilizumab (TCZ; n = 234), etanercept (ETN; n = 184), golimumab (GLM; n = 159), infliximab (IFX; n = 101), adalimumab (ADA; n = 97), and certolizumab pegol (CZP; n = 51). Drug retention rates and discontinuation reasons were estimated at 36 months using the Kaplan-Meier method and adjusted for potential clinical confounders (age, sex, disease duration, concomitant PSL and MTX, starting date and switched number of bDMARDs) by Cox proportional hazards modeling. Results: A total of 51.2% of treatment courses were stopped, with 25.1% stopping due to lack of effectiveness, 11.8% due to toxic adverse events, 9.7% due to non-toxic reasons, and 4.6% due to remission. Drug retention rates for each discontinuation reason were as follows; lack of effectiveness [from 55.4% (ETN) to 81.6% (ABT); with significant differences between groups (Cox P<0.001)], toxic adverse events [from 79.3% (IFX) to 95.4% (ABT), Cox P = 0.043], and remission [from 94.2% (TCZ) to 100.0% (CZP), Cox P = 0.58]. Finally, overall retention rates excluding non-toxic reasons and remission for discontinuation ranged from 50.0% (ETN) to 78.1% (ABT) (Cox P<0.001). Conclusions: ABT showed lowest discontinuation rate by lack of effectiveness and by toxic adverse events, which lead to highest overall retention rates (excluding non-toxic reasons and remission) among seven bDMARDs in adjusted model of elderly RA patients.
Description: Ebina, K., Hashimoto, M., Yamamoto, W. et al. Correction to: Drug tolerability and reasons for discontinuation of seven biologics in 4466 treatment courses of rheumatoid arthritis -the ANSWER cohort study-. Arthritis Res Ther 21, 114 (2019).
Rights: © 2019 Ebina et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
DOI(Published Version): 10.1371/journal.pone.0216624
PubMed ID: 31067271
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