Persistence with anti-tumour necrosis factor therapies in patients with psoriatic arthritis: observational study from the British Society of Rheumatology Biologics Register.
Persistence with anti-tumour necrosis factor therapies in patients with psoriatic arthritis: observational study from the British Society of Rheumatology Biologics Register.
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DOI：
10.1186/ar2670
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发表时间：
2009
影响因子：
4.9
通讯作者：
British Society for Rheumatology Biologics Register
中科院分区：
文献类型：
--
作者：
Saad AA;Ashcroft DM;Watson KD;Hyrich KL;Noyce PR;Symmons DP;British Society for Rheumatology Biologics Register
抗肿瘤坏死因子治疗代表了严重银屑病关节炎治疗的突破。然而，在常规临床实践中，对银屑病关节炎患者长期使用这些治疗药物的情况知之甚少。本研究的目的是评估在银屑病关节炎患者的前瞻性队列中使用抗肿瘤坏死因子治疗的第一疗程和第二疗程的持续性，并确定与停药相关的因素和原因。共有566例银屑病关节炎患者在英国风湿病生物制剂协会注册（第一种抗肿瘤坏死因子药物：依那西普，n = 316；英夫利昔单抗，n = 162；阿达木单抗，n = 88）。治疗医生完成了6个月的随访问卷，详细说明了抗tnf治疗的变化。使用Kaplan-Meier生存分析检查治疗的持久性。停药的原因分为无效、不良事件或其他原因。利用一系列人口统计学、基线疾病特异性和治疗变量，建立了单因素和多因素Cox比例风险模型，以检查因无效或不良事件而停药的潜在预测因素。基线时，患者的平均（标准差）年龄为45.7（11.1）岁，53%为女性，平均病程为12.4（8.7）年。平均（标准差）随访2.3（0.9）人年，可获得持续性数据。总共有422名患者完成了至少12个月的随访，其中75.5%的患者仍在使用第一个抗tnf药物，9.5%的患者因无效而停药，10.0%的患者因不良事件而停药，5.0%的患者因其他原因而停药。在随访期间，178名患者接受了第二次抗tnf治疗。第二次抗肿瘤坏死因子转换患者12个月时的存活功能为74%。银屑病关节炎患者在初始和第二次抗肿瘤坏死因子治疗中表现出较高的持续率。
Anti-TNF therapies represent a breakthrough in the treatment of severe psoriatic arthritis. However, little is known about long-term drug persistence with these treatments in patients with psoriatic arthritis in routine clinical practice. The aim of this study was to assess persistence with first-course and second-course treatment with anti-TNF agents in a prospective cohort of psoriatic arthritis patients and to identify factors associated with and reasons for drug discontinuation. A total of 566 patients with psoriatic arthritis were registered with the British Society for Rheumatology Biologics Register (first anti-TNF agent: etanercept, n = 316; infliximab, n = 162; and adalimumab, n = 88). Treating physicians completed 6-monthly follow-up questionnaires detailing changes to anti-TNF therapies. Persistence with treatment was examined using Kaplan–Meier survival analysis. Reasons for withdrawal were classified as due to inefficacy, adverse events or other reasons. Univariate and multivariate Cox proportional hazard models were developed to examine potential predictors of withdrawals due to inefficacy or adverse events, using a range of demographic, baseline disease-specific and therapeutic variables. At baseline, the mean (standard deviation) age of patients was 45.7 (11.1) years, 53% were female and the mean disease duration was 12.4 (8.7) years. Persistence data were available for a mean (standard deviation) follow-up of 2.3 (0.9) person-years. In total, 422 patients had completed at least 12 months of follow-up, 75.5% of whom remained on their first anti-TNF drug while 9.5% discontinued due to inefficacy, 10.0% due to adverse events and 5.0% due to other reasons. During the period of follow-up, 178 patients received a second anti-TNF therapy. The survivor function on second anti-TNF for switchers was 74% at 12 months. Psoriatic arthritis patients show high persistence rates with both initial and second anti-TNF therapies.
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影响因子：
--
作者：
Antoni, CE;Kavanagh, A;Smolen, J
通讯作者：
Smolen, J
影响因子：
--
作者：
Hyrich, Kimme L.;Lunt, Mark;Silman, Alan J.
通讯作者：
Silman, Alan J.
影响因子：
168.9
作者：
Mease, PJ;Goffe, BS;Burge, DJ
通讯作者：
Burge, DJ
影响因子：
4.2
作者：
Bousquet, C;Lagier, G;Jaulent, MC
通讯作者：
Jaulent, MC
DOI：
10.1002/art.23333
发表时间：
2008-02-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Heiberg, Marte Schrumpf;Koldingsnes, Wenche;Kvien, Tore K.
通讯作者：
Kvien, Tore K.