Impact of inadequate adherence on response to subcutaneously administered anti-tumour necrosis factor drugs: results from the Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate cohort.
Impact of inadequate adherence on response to subcutaneously administered anti-tumour necrosis factor drugs: results from the Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate cohort.
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DOI：
10.1093/rheumatology/keu358
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发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
BRAGGSS
中科院分区：
文献类型：
--
作者：
Bluett J;Morgan C;Thurston L;Plant D;Hyrich KL;Morgan AW;Wilson AG;Isaacs JD;Cordingley L;Barton A;BRAGGSS
目标。不坚持DMARDS是常见的，但对坚持生物疗法及其与治疗反应的关系知之甚少。这项研究的目的是调查自我报告的不遵守S.C.类风湿关节炎患者的抗肿瘤坏死因子治疗和反应。方法：研究方法。与会者即将启动S.C.抗肿瘤坏死因子治疗被纳入英国一项大型多中心前瞻性观察队列研究。在基线上评估人口统计信息和疾病特征。在治疗开始后的3个月和6个月，记录自我报告的不依从性，定义为之前适当的生物治疗剂量是否报告为在与卫生保健专业人员商定的那一天没有服用。在基线、治疗3个月和6个月后记录28个关节的DAS(DAS28)。用多元线性回归检验这些关系。结果。392例患者的中位病程为7年[四分位数范围3-15]。286名患者获得了依从性数据。在这些人中，27%的人报告在前6个月内至少一次没有按照定义的标准进行生物治疗。在多变量线性回归分析中，年龄较大、基线DAS28较低、在距基线3个月或6个月时从未坚持DAS28与6个月时DAS28对抗肿瘤坏死因子治疗的反应较差显著相关。结论。报告在与医疗保健专业人员达成一致的当天没有服用生物制剂的类风湿关节炎患者显示出比他们的同行更差的临床结果，强调需要调查不坚持生物制剂的原因。
Objective. Non-adherence to DMARDs is common, but little is known about adherence to biologic therapies and its relationship to treatment response. The purpose of this study was to investigate the association between self-reported non-adherence to s.c. anti-TNF therapy and response in individuals with RA. Methods. Participants about to start s.c. anti-TNF therapy were recruited to a large UK multicentre prospective observational cohort study. Demographic information and disease characteristics were assessed at baseline. Self-reported non-adherence, defined as whether the previous due dose of biologic therapy was reported as not taken on the day agreed with the health care professional, was recorded at 3 and 6 months following the start of therapy. The 28-joint DAS (DAS28) was recorded at baseline and following 3 and 6 months of therapy. Multivariate linear regression was used to examine these relationships. Results. Three hundred and ninety-two patients with a median disease duration of 7 years [interquartile range (IQR) 3–15] were recruited. Adherence data were available in 286 patients. Of these, 27% reported non-adherence to biologic therapy according to the defined criteria at least once within the first 6-month period. In multivariate linear regression analysis, older age, lower baseline DAS28 and ever non-adherence at either 3 or 6 months from baseline were significantly associated with a poorer DAS28 response at 6 months to anti-TNF therapy. Conclusion. Patients with RA who reported not taking their biologic on the day agreed with their health care professional showed poorer clinical outcomes than their counterparts, emphasizing the need to investigate causes of non-adherence to biologics.
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影响因子：
4.2
作者：
Atzeni, Fabiola;Bongiovanni, Sara;Sarzi-Puttini, Piercarlo
通讯作者：
Sarzi-Puttini, Piercarlo
影响因子：
4.5
作者：
Li, Pengxiang;Blum, Marissa A.;Doshi, Jalpa A.
通讯作者：
Doshi, Jalpa A.
影响因子：
9.6
作者：
Horne, Rob
通讯作者：
Horne, Rob
影响因子：
2.3
作者：
Borah, Bijan J.;Huang, Xingyue;Globe, Denise
通讯作者：
Globe, Denise
影响因子：
5.8
作者：
Malaviya, Anshuman P.;Oestoer, Andrew J. K.
通讯作者：
Oestoer, Andrew J. K.