Median time to discontinuation longer for those receiving tumor necrosis factor inhibitors
MONDAY, June 17 (HealthDay News) -- For patients with rheumatoid arthritis (RA), the median time to discontinuation of therapy is 25.1 months, with longer time to discontinuation noted for those receiving tumor necrosis factor inhibitors (TNFi's), according to a study presented at the annual meeting of the European League Against Rheumatism, held from June 12 to 15 in Madrid.
Vibeke Strand, M.D., from Stanford University in Palo Alto, Calif., and colleagues used data from the U.S. Consortium of Rheumatology Researchers of North America (CORRONA) database to examine the initiation of biologic therapy and characterize reasons for discontinuation for adults (age 18 years or older) with RA onset at older than 16 years and who were followed for six months or more after therapy initiation.
A total of 6,209 patients with RA (78.5 percent female; mean age, 57.6 years; median RA duration, eight years) met the inclusion criteria. The researchers found that 80.7 percent were receiving TNFi's. At six months and one year, 82.2 and 67.3 percent, respectively, remained on initiated medication, with the median time to discontinuation or change of therapy 25.1 months. The median time to discontinuation was significantly longer for those receiving TNFi's versus non-TNFi's (26.5 versus 20.5 months). At six, 12, and 24 months, the proportion receiving TNFi's were 82.5, 68.2, and 52.2 percent, respectively, compared with 80.9, 63.4, and 46.0 percent for those receiving non-TNFi's. Reasons captured for the 3,584 discontinuations included loss of efficacy (35.8 percent), safety (20.1 percent), physician preference (27.8 percent), patient preference (17.9 percent), and access to treatment (9.0 percent).
"Studies have shown that patients sustain maximum benefit from RA treatment in the first two years -- yet our data highlight significant discontinuation rates during this time period," Strand said in a statement.
Several authors disclosed financial ties to CORRONA, AstraZeneca, and Axio Research.
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