Clinical factors associated with discontinuation of ts/bDMARDs in rheumatic patients from the BIOBADASER III registry
Prior-Español, Águeda (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Sánchez-Piedra, C. (Sociedad Española de Reumatología)
Campos, J. (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Manero Ruiz, Francisco Javier (Hospital Universitario Miguel Servet (Saragossa))
Pérez-García, C. (Hospital del Mar (Barcelona, Catalunya))
Bohórquez, C. (Hospital Universitario Príncipe de Asturias (Alcalá de Henares, Madrid))
Busquets-Pérez, N. (Hospital General de Granollers)
Blanco-Madrigal, J.M. (Hospital de Basurto (Bilbao, Biscaia))
Díaz Torne, César (Institut d'Investigació Biomèdica Sant Pau)
Sánchez-Alonso, F. (Sociedad Española de Reumatología)
Mateo, L. (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Holgado Pérez, Susana (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)

Date:	2021
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.
Note:	Altres ajuts: Spanish Agency of Medicines and Medical Devices (AEMPS); Biogen; Bristol Myers-Squibb (BMS); Celltrion Healthcare; Lilly; Merck; Novartis; Pfizer; Regeneron Pharmaceuticals; Samsung Bioepis.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Adult ; Aged ; Antirheumatic Agents ; Arthritis, Psoriatic ; Arthritis, Rheumatoid ; Biological Products ; Female ; Humans ; Male ; Middle Aged ; Registries ; Retrospective Studies ; Risk Factors ; Spondylitis, Ankylosing ; Withholding Treatment
Published in:	Scientific reports, Vol. 11 Núm. 1 (december 2021) , p. 11091, ISSN 2045-2322

DOI: 10.1038/s41598-021-90442-w
PMID: 34045525

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles