Persistence on biologic DMARD monotherapy after achieving rheumatoid arthritis disease control on combination therapy: retrospective analysis of corrona registry data.
Persistence on biologic DMARD monotherapy after achieving rheumatoid arthritis disease control on combination therapy: retrospective analysis of corrona registry data.
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在实现类风湿性关节炎疾病控制后坚持生物DMARD单一疗法：CORRONA登记数据的回顾分析。
DOI：
10.1007/s00296-020-04667-5
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发表时间：
2021-03
影响因子：
4
通讯作者：
Stryker S
中科院分区：
文献类型：
--
作者：
Pappas DA;Litman HJ;Lesperance T;Kricorian G;Karis E;Rebello S;Hua W;Accortt NA;Stryker S
与常规合成抗风湿药物(CsDMARD)联合治疗相比，生物抗风湿药物(BDMARD)单一疗法可以提高依从性并减少不良事件；然而，bDMARD单一疗法的持久性尚未得到广泛研究。我们探讨了依那西普单一疗法以及与其他肿瘤坏死因子抑制剂(TNFis)的单一疗法在首次获得缓解/低疾病活动度(LDA)的患者中的持久性，同时进行了csDMARDS和TNFi的联合治疗。使用CORRONA登记数据，确定持续使用TNFi指数(依那西普与其他TNFis)超过6个月和12个月的患者的百分比。观察6个月和12个月时影响持久性的因素和治疗方式。在617名符合条件的患者中，182名服用依那西普的患者中有56%的患者和435名接受其他TNFis的患者中有45%的人在6个月时坚持单一疗法，在12个月时分别为46%和33%。在一线和后续的生物DMARD中，依那西普的持久性在6个月时比其他TNFi持久性高10.8%(95%可信区间2.1%，19.6%)，在12个月时高11.4%(95%可信区间0.9%，21.9%)。服用其他TNFis的患者在6个月后更有可能需要重新引入csDMARD(45%比依那西普的35%)。缓解是依那西普和其他TNFi单一疗法持续的关键预测因素。这项对登记数据的回顾性队列研究反映了现实世界的实践，表明通过csDMARD和TNFi联合治疗获得缓解/LDA的患者可以成功过渡到TNFi单一治疗。接受依那西普单一治疗的患者与接受其他TNFi单一治疗的患者相比，经历了更大的持久性和更少的csDMARD重新引入。
Biological disease-modifying antirheumatic drugs (bDMARDs) monotherapy may enhance adherence and decrease adverse events compared to combination therapy with conventional synthetic DMARDs (csDMARDs); however, persistence with bDMARD monotherapy has not been extensively studied. We explore persistence of etanercept monotherapy and monotherapy with other tumor necrosis factor inhibitors (TNFis) among patients first achieving remission/low disease activity (LDA) while on combination therapy with csDMARDs and a TNFi. Using Corrona registry data, the percentage of patients persistent with the index TNFi (etanercept versus other TNFis) over 6 and 12 months was determined. Factors influencing persistence and treatment patterns at 6 and 12 months were examined. Among 617 eligible patients, 56% of 182 patients on etanercept and 45% of 435 patients on other TNFis persisted with monotherapy at 6 months, 46% and 33%, respectively, at 12 months. Across first-line and subsequent biologic DMARDs, etanercept persistence was greater than other TNFi persistence by 10.8% (95% CI 2.1%, 19.6%) at 6 months and 11.4% (95% CI 0.9%, 21.9%) at 12 months. Patients on other TNFis were more likely to require reintroduction of csDMARD after 6 months (45% versus 35% for etanercept). Remission was the key predictor of persistence for both etanercept and other TNFi monotherapies. This retrospective, cohort study of registry data reflecting real-world practice indicates patients who achieve remission/LDA with combination csDMARD and TNFi therapy may successfully transition to TNFi monotherapy. Patients on etanercept monotherapy experienced greater persistence and less frequent reintroduction of a csDMARD than was observed for patients on other TNFi monotherapies.
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影响因子：
--
作者：
Myasoedova, Elena;Crowson, Cynthia S.;Kremers, Hilal Maradit;Therneau, Terry M.;Gabriel, Sherine E.
通讯作者：
Gabriel, Sherine E.
影响因子：
1.2
作者：
Mori, Shunsuke;Yoshitama, Tamami;Ueki, Yukitaka
通讯作者：
Ueki, Yukitaka
影响因子：
6.2
作者：
Mease, Philip J.;Karki, Chitra;Greenberg, Jeffrey D.
通讯作者：
Greenberg, Jeffrey D.
影响因子：
4.2
作者：
Daien, Claire;Hua, Charlotte;Combe, Bernard
通讯作者：
Combe, Bernard
影响因子：
27.4
作者：
Salliot C;van der Heijde D
通讯作者：
van der Heijde D