Treatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)

Mustafa Acar,1 Prabhjot Juneja,2 Malcolm Handel1 1Janssen-Cilag Pty Ltd, Sydney, NSW, Australia; 2Prospection Pty Ltd., Sydney, NSW, Australia Introduction: To describe the persistence of treatment with subcutaneous tumor necrosis factor inhibitors (TNFi) adalimumab, etanercept, and golimumab in imm...

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Autores principales:	Acar M, Juneja P, Handel M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	tumor necrosis factor inhibitor arthritis psoriatic rheumatoid arthritis ankylosing spondylitis treatment persistence Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/6873efba7f714c849d6e435727815f60
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spelling	oai:doaj.org-article:6873efba7f714c849d6e435727815f602021-12-02T02:19:05ZTreatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)1179-156Xhttps://doaj.org/article/6873efba7f714c849d6e435727815f602018-11-01T00:00:00Zhttps://www.dovepress.com/treatment-persistence-of-subcutaneous-tnf-inhibitors-among-australian--peer-reviewed-article-OARRRhttps://doaj.org/toc/1179-156XMustafa Acar,1 Prabhjot Juneja,2 Malcolm Handel1 1Janssen-Cilag Pty Ltd, Sydney, NSW, Australia; 2Prospection Pty Ltd., Sydney, NSW, Australia Introduction: To describe the persistence of treatment with subcutaneous tumor necrosis factor inhibitors (TNFi) adalimumab, etanercept, and golimumab in immune-mediated rheumatic disease (rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis) by treatment sequence (first-line treatment, second-line or further lines of treatment). Methods: A retrospective cohort analysis was conducted using the Australian Commonwealth Department of Human Services Pharmaceutical Benefits Scheme 10% sample data from January 1, 2010, to June 30, 2016. Pharmaceutical Benefits Scheme indications were used to identify patient prescriptions for rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. A patient was considered persistent until a 3-month gap period where a prescription was not dispensed. The 3-month gap interval was chosen because only 1% of all discontinuations occurred beyond this 3-month period. Results: Data from 2,612 first-line patients were included. Treatment discontinuation among first-line patients treated with etanercept or adalimumab was not significantly different from those treated with golimumab (HR 1.10, 95% CI 0.95–1.28, P=0.22; HR 1.06, 95% CI 0.93–1.22, P=0.39; respectively). Among the 1,276 patients in the second-line cohort (etanercept=41%, adalimumab=41%, golimumab=18%) discontinuation was significantly higher for patients on etanercept compared with golimumab (HR 1.24, 95% CI 1.03–1.50, P=0.03); but not for adalimumab compared with golimumab (HR 1.11, 95% CI 0.91–1.34, P=0.31). In the third-line setting, treatment persistence with etanercept was longer than golimumab (HR 0.75, 95% CI 0.59–0.96, P=0.02), but there was no difference between golimumab and adalimumab. Similar findings occurred in the propensity score matched population. Conclusion: Our study shows there is variance in real-world persistence to TNFi in patients with immune-mediated rheumatic disease by line of therapy, with the time on therapy decreasing by line. Australian persistence has been reported at lower overall rates than international evidence. Keywords: tumor necrosis factor inhibitors, arthritis, psoriatic, rheumatoid arthritis, ankylosing spondylitis, treatment persistenceAcar MJuneja PHandel MDove Medical Pressarticletumor necrosis factor inhibitorarthritispsoriaticrheumatoid arthritisankylosing spondylitistreatment persistenceDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol Volume 10, Pp 151-160 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	tumor necrosis factor inhibitor arthritis psoriatic rheumatoid arthritis ankylosing spondylitis treatment persistence Diseases of the musculoskeletal system RC925-935
spellingShingle	tumor necrosis factor inhibitor arthritis psoriatic rheumatoid arthritis ankylosing spondylitis treatment persistence Diseases of the musculoskeletal system RC925-935 Acar M Juneja P Handel M Treatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)
description	Mustafa Acar,1 Prabhjot Juneja,2 Malcolm Handel1 1Janssen-Cilag Pty Ltd, Sydney, NSW, Australia; 2Prospection Pty Ltd., Sydney, NSW, Australia Introduction: To describe the persistence of treatment with subcutaneous tumor necrosis factor inhibitors (TNFi) adalimumab, etanercept, and golimumab in immune-mediated rheumatic disease (rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis) by treatment sequence (first-line treatment, second-line or further lines of treatment). Methods: A retrospective cohort analysis was conducted using the Australian Commonwealth Department of Human Services Pharmaceutical Benefits Scheme 10% sample data from January 1, 2010, to June 30, 2016. Pharmaceutical Benefits Scheme indications were used to identify patient prescriptions for rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. A patient was considered persistent until a 3-month gap period where a prescription was not dispensed. The 3-month gap interval was chosen because only 1% of all discontinuations occurred beyond this 3-month period. Results: Data from 2,612 first-line patients were included. Treatment discontinuation among first-line patients treated with etanercept or adalimumab was not significantly different from those treated with golimumab (HR 1.10, 95% CI 0.95–1.28, P=0.22; HR 1.06, 95% CI 0.93–1.22, P=0.39; respectively). Among the 1,276 patients in the second-line cohort (etanercept=41%, adalimumab=41%, golimumab=18%) discontinuation was significantly higher for patients on etanercept compared with golimumab (HR 1.24, 95% CI 1.03–1.50, P=0.03); but not for adalimumab compared with golimumab (HR 1.11, 95% CI 0.91–1.34, P=0.31). In the third-line setting, treatment persistence with etanercept was longer than golimumab (HR 0.75, 95% CI 0.59–0.96, P=0.02), but there was no difference between golimumab and adalimumab. Similar findings occurred in the propensity score matched population. Conclusion: Our study shows there is variance in real-world persistence to TNFi in patients with immune-mediated rheumatic disease by line of therapy, with the time on therapy decreasing by line. Australian persistence has been reported at lower overall rates than international evidence. Keywords: tumor necrosis factor inhibitors, arthritis, psoriatic, rheumatoid arthritis, ankylosing spondylitis, treatment persistence
format	article
author	Acar M Juneja P Handel M
author_facet	Acar M Juneja P Handel M
author_sort	Acar M
title	Treatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)
title_short	Treatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)
title_full	Treatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)
title_fullStr	Treatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)
title_full_unstemmed	Treatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)
title_sort	treatment persistence of subcutaneous tnf inhibitors among australian patients with immune-mediated rheumatic disease (imrd)
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/6873efba7f714c849d6e435727815f60
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Treatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)

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