The comparative one-year performance of anti-tumor necrosis factor α drugs in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis:: Results from a longitudinal, observational, multicenter study
The comparative one-year performance of anti-tumor necrosis factor α drugs in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis:: Results from a longitudinal, observational, multicenter study
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DOI：
10.1002/art.23333
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发表时间：
2008-02-15
期刊：
影响因子：
--
通讯作者：
Kvien, Tore K.
中科院分区：
文献类型：
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作者：
Heiberg, Marte Schrumpf;Koldingsnes, Wenche;Kvien, Tore K.
目标。比较类风湿关节炎（RA）、银屑病关节炎（PsA）和强直性脊柱炎（AS）患者抗肿瘤坏死因子α (anti-TNF α)药物1年的保留率，并对其健康状况的影响进行互补分析。我们的分析分别包括RA、PsA和AS患者的847、172和249个抗tnf α治疗疗程。比较粗药物生存期，并计算治疗终止的风险比（hr），调整年龄、性别、研究者的总体评估和伴随的甲氨蝶呤（MTX）。比较两组患者健康相关生活质量（HRQOL）的调整变化。RA组、PsA组和AS组未经调整的1年保留率分别为65.4%、77.3%和77.5%。PsA与RA的治疗终止校正hr为0.76(95%可信区间[95% CI] 0.53-1.07)， AS与RA的治疗终止校正hr为0.66 （95% CI 0.47-0.92）。高基线疾病活动度和女性与过早终止治疗显着相关，而同时使用MTX与更好的药物生存相关。然而，在分层分析中，MTX对RA和PsA的影响很明显，但对AS的影响不明显。PsA和AS患者HRQOL的改善优于ra。我们的研究结果表明，与RA患者相比，抗tnf α治疗在AS和PsA患者中的生存率更高。颈椎病患者HRQOL的较大改善可能有助于药物生存的差异。在RA和PsA患者中，同时使用MTX与更好的保留率相关，但在AS患者中没有。
Objective. To compare the 1-year retention rates of anti-tumor necrosis factor alpha (anti-TNF alpha) medications in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) with complementary analyses of the effect on health status.Methods. Our analyses comprised 847, 172, and 249 anti-TNF alpha treatment courses in patients with RA, PsA, and AS, respectively. Crude drug survival was compared and hazard ratios (HRs) for treatment termination were calculated with adjustments for age, sex, investigator's global assessment, and concomitant rnethotrexate (MTX). Adjusted changes in health-related quality of life (HRQOL) were compared among the groups.Results. Unadjusted 1-year retention rates were 65.4%, 77.3%, and 77.5% in the RA, PsA, and AS groups, respectively. The adjusted HRs for treatment termination were 0.76 (95% confidence interval [95% CI] 0.53-1.07) for PsA versus RA and 0.66 (95% CI 0.47-0.92) for AS versus RA. High baseline disease activity and female sex were significantly associated with premature treatment termination, whereas concomitant MTX was associated with better drug survival. However, the impact of MTX was apparent for RA and PsA, but not for AS in stratified analyses. The improvements in HRQOL were superior in patients with PsA and AS compared with RA.Conclusion. Our results suggest that survival of anti-TNF alpha treatment is superior in AS and PsA patients compared with RA patients. Larger improvements in HRQOL in patients with spondylarthritides may contribute to the differences in drug survival. Concomitant MTX was associated with better retention rates in RA and PsA patients, but not AS patients.