Rate and Causes of Infliximab Discontinuation in Patients With Rheumatoid Arthritis in a Private Clinical Practice
Rate and Causes of Infliximab Discontinuation in Patients With Rheumatoid Arthritis in a Private Clinical Practice
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DOI：
10.1097/rhu.0b013e31817a7e0e
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发表时间：
2008-12-01
影响因子：
3.4
通讯作者：
Strusberg, Alberto M.
中科院分区：
文献类型：
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作者：
Bertoli, Ana M.;Strusberg, Ingrid;Strusberg, Alberto M.
目的：描述英夫利西单抗停药率和这一事件的原因在人群中的类风湿关节炎patients.Patients和方法：风湿性关节炎患者从门诊私人中心英夫利西单抗治疗（至少2个连续剂量）进行了回顾性研究。通过Kaplan-Meier生存法检查英夫利西单抗停药率。单变量和多变量考克斯比例风险回归分析与英夫利西单抗停药相关的变量进行了分析。结果：2000年8月至2006年12月，77例患者与英夫利西单抗治疗确定，其中，33（43%）停止这种药物。12、24和36个月时的累积停药率分别为23%、35%和43%。停药的原因是药物相关的不良反应（41%），经济限制（15%），缺乏疗效（12%）和其他（32%）。与英夫利西单抗停药独立相关的变量是英夫利西单抗治疗期间平均压痛关节的数量[风险比（HR）= 1.17，95%置信区间（CI）1.05- 1.31; P = 0.005]和英夫利西单抗引起的任何不良反应的发生率（HR = 2.86，95% CI 1.37-7.19; P1 = 0.026），而英夫利西单抗的全药房覆盖率（HR = 0.32，95% CI 0.026）。13-0.79，P = 0.014.Conclusion：43%的患者在3年后停用英夫利西单抗，其中大部分是因为不良反应和经济拮据。风湿病学家应该意识到，那些疾病活动性更强的患者也有更高的风险停用英夫利昔单抗。
Objectives: To describe the rate of infliximab discontinuation and the causes of this event in a population of rheumatoid arthritis patients.Patients and Methods: Rheumatoid arthritis patients from an outpatient private center treated with infliximab (at least 2 consecutive doses) were retrospectively studied. The infliximab discontinuation rate was examined by the Kaplan-Meier survival method. Variables associated with infliximab discontinuation were analyzed by univariable and multivariable Cox proportional hazards regression analyses.Results: Seventy-seven patients treated with infliximab between August 2000 and December 2006 were identified; of them, 33 (43%) discontinued this drug. The cumulative discontinuation rate was of 23%, 35%, and 43% at 12, 24, and 36 months, respectively. Causes of discontinuation were drug-related adverse reactions (41 %), financial constraints (15%), lack of efficacy (12%), and others (32%). Variables independently associated with infliximab discontinuation were the number of tender joints on an average during infliximab treatment [hazard ratio (HR) = 1.17, 95% confidence interval (Cl) 1.05-1.3 1; P = 0.005] and the occurrence of any adverse reaction attributed to infliximab (HR = 2.86, 95% Cl 1.37-7.19; P, = 0.026), whereas having full pharmacy coverage for infliximab (HR = 0.32, 95% Cl 0. 13-0.79, P = 0.014) was protective.Conclusion: Forty-three percent of patients discontinued infliximab at 3 years; most of them because of adverse reactions and financial constraints. Rheumatologists should be aware that those patients with more active disease were also at higher risk of discontinuing inflixiimab.