Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry

Abstract Biologic and targeted synthetic disease-modifying antirheumatic drugs (ts/bDMARDs) play a pivotal role in the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Persistence of therapy provides an index of a drug’s overall effectiveness. The o...

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Autores principales:	A. Prior-Español, C. Sánchez-Piedra, J. Campos, F. J. Manero, C. Pérez-García, C. Bohórquez, N. Busquets-Pérez, J. M. Blanco-Madrigal, C. Díaz-Torne, F. Sánchez-Alonso, L. Mateo, S. Holgado-Pérez
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6b574cc67451470a97090fb433d3f615
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spelling	oai:doaj.org-article:6b574cc67451470a97090fb433d3f6152021-12-02T15:49:28ZClinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry10.1038/s41598-021-90442-w2045-2322https://doaj.org/article/6b574cc67451470a97090fb433d3f6152021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90442-whttps://doaj.org/toc/2045-2322Abstract Biologic and targeted synthetic disease-modifying antirheumatic drugs (ts/bDMARDs) play a pivotal role in the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Persistence of therapy provides an index of a drug’s overall effectiveness. The objective of the study was to identify factors associated with discontinuation of ts/bDMARDs in a real-world dataset. The study population comprised patients diagnosed with RA, PsA, and AS included in the BIOBADASER registry for whom follow-up data were available until November 2019. Patient features and treatment data were included in the analysis. The Kaplan–Meier method was used to study survival of the different drugs according to the reason for discontinuation. Factors associated with discontinuation were studied using Cox regression models and bivariate and multivariate analyses. P values of less than 0.05 were regarded as statistically significant. The study population comprised 4,752 patients who received a total of 8,377 drugs, of which 4,411 (52.65%) were discontinued. The Kaplan–Meier curves showed that survival for first-line treatment was greater in all 3 groups (p < 0.001). Patients with RA had a greater risk of discontinuation if they were younger (HR, 0.99; 95% CI 0.99–1.00), if they were receiving anti-TNFα agents (HR, 0.61; 95% CI 0.54–0.70), and if they had more comorbid conditions (HR, 1.09; 95% CI 1.00–1.17). Patients with PsA had a higher risk if they were women (HR, 1.36; 95% CI 1.15–1.62) and if they were receiving other ts/bDMARDs (HR, 1.29; 95% CI 1.05–1.59). In patients with AS, risk increased with age (HR, 1.01; 95% CI 1.00–1.02), as did the number of comorbid conditions (HR, 1.27; 95% CI 1.12–1.45). The factors that most affected discontinuation of ts/bDMARDs were line of treatment, age, type of drug, sex, comorbidity and the year of initiation of treatment. The association with these factors differed with each disease, except for first-line treatment, which was associated with a lower risk of discontinuation in all 3 diseases.A. Prior-EspañolC. Sánchez-PiedraJ. CamposF. J. ManeroC. Pérez-GarcíaC. BohórquezN. Busquets-PérezJ. M. Blanco-MadrigalC. Díaz-TorneF. Sánchez-AlonsoL. MateoS. Holgado-PérezNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q A. Prior-Español C. Sánchez-Piedra J. Campos F. J. Manero C. Pérez-García C. Bohórquez N. Busquets-Pérez J. M. Blanco-Madrigal C. Díaz-Torne F. Sánchez-Alonso L. Mateo S. Holgado-Pérez Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry
description	Abstract Biologic and targeted synthetic disease-modifying antirheumatic drugs (ts/bDMARDs) play a pivotal role in the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Persistence of therapy provides an index of a drug’s overall effectiveness. The objective of the study was to identify factors associated with discontinuation of ts/bDMARDs in a real-world dataset. The study population comprised patients diagnosed with RA, PsA, and AS included in the BIOBADASER registry for whom follow-up data were available until November 2019. Patient features and treatment data were included in the analysis. The Kaplan–Meier method was used to study survival of the different drugs according to the reason for discontinuation. Factors associated with discontinuation were studied using Cox regression models and bivariate and multivariate analyses. P values of less than 0.05 were regarded as statistically significant. The study population comprised 4,752 patients who received a total of 8,377 drugs, of which 4,411 (52.65%) were discontinued. The Kaplan–Meier curves showed that survival for first-line treatment was greater in all 3 groups (p < 0.001). Patients with RA had a greater risk of discontinuation if they were younger (HR, 0.99; 95% CI 0.99–1.00), if they were receiving anti-TNFα agents (HR, 0.61; 95% CI 0.54–0.70), and if they had more comorbid conditions (HR, 1.09; 95% CI 1.00–1.17). Patients with PsA had a higher risk if they were women (HR, 1.36; 95% CI 1.15–1.62) and if they were receiving other ts/bDMARDs (HR, 1.29; 95% CI 1.05–1.59). In patients with AS, risk increased with age (HR, 1.01; 95% CI 1.00–1.02), as did the number of comorbid conditions (HR, 1.27; 95% CI 1.12–1.45). The factors that most affected discontinuation of ts/bDMARDs were line of treatment, age, type of drug, sex, comorbidity and the year of initiation of treatment. The association with these factors differed with each disease, except for first-line treatment, which was associated with a lower risk of discontinuation in all 3 diseases.
format	article
author	A. Prior-Español C. Sánchez-Piedra J. Campos F. J. Manero C. Pérez-García C. Bohórquez N. Busquets-Pérez J. M. Blanco-Madrigal C. Díaz-Torne F. Sánchez-Alonso L. Mateo S. Holgado-Pérez
author_facet	A. Prior-Español C. Sánchez-Piedra J. Campos F. J. Manero C. Pérez-García C. Bohórquez N. Busquets-Pérez J. M. Blanco-Madrigal C. Díaz-Torne F. Sánchez-Alonso L. Mateo S. Holgado-Pérez
author_sort	A. Prior-Español
title	Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry
title_short	Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry
title_full	Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry
title_fullStr	Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry
title_full_unstemmed	Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry
title_sort	clinical factors associated with discontinuation of ts/bdmards in rheumatic patients from the biobadaser iii registry
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/6b574cc67451470a97090fb433d3f615
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Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry

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