Objectives: This study aims to investigate the factors associated with early discontinuation (within one year) of etanercept (ETA) in rheumatoid arthritis (RA) patients who began ETA as first biologic disease-modifying antirheumatic drug (bDMARD) and who were entered into the Gruppo Italiano di Studio sulla Early Arthritis (Italian Group for the Study of Early Arthritis; GISEA) registry.Patients and methods: This registry-based cohort study included 477 RA patients (95 males, 382 females; median age 53 years; range 18 to 83 years) who began ETA as first bDMARD. Patient demographics, disease features and drugs were re-evaluated after 12 months. Baseline predictors of ETA discontinuation were estimated by univariate and multivariate analyses using Cox regression model.Results: Seventy patients (14.7%) discontinued ETA during the first year (for inefficacy in 55.8%, adverse events in 28.6%, and other reasons in 6.5%). Concurrent conventional synthetic DMARDs (csDMARDs) were reported in 54.3% of patients, mainly methotrexate (MTX), while 52.4% of subjects took low doses of glucocorticoids. Patients stopping ETA more frequently showed one or more comorbidities, mainly cardiovascular diseases (28.6% vs. 15.7% in patients stopping and continuing ETA, respectively, p=0.009). The presence of comorbidities and a combination therapy with csDMARDs other than MTX were independent factors associated with early discontinuation of ETA at multivariate Cox analysis.Conclusion: Although ETA demonstrated a high persistence in biologic-naive RA patients, about 15% of patients discontinued the treatment within 12 months. The presence of comorbidities and a combination therapy with csDMARDs other than MTX were the main factors for an early withdrawal of the drug.

Factors Predicting Early Failure of Etanercept in Rheumatoid Arthritis: An Analysis From the Gruppo Italiano di Studio sulla Early Arthritis (Italian Group for the Study of Early Arthritis) Registry / Sebastiani, M; Manfredi, A; Iannone, F; Gremese, E; Bortoluzzi, A; Favalli, E; Bazzani, C; Salaffi, F; Fusaro, E; Foti, R; Giannitti, C; Caporali, R; Gauli, A; Cassone, G; Lopalco, G; Petricca, L; Ferraccioli, G; Lapadula, G. - In: ARCHIVES OF RHEUMATOLOGY. - ISSN 2148-5046. - 35:2(2020), pp. 163-169. [10.46497/ArchRheumatol.2020.7499]

Factors Predicting Early Failure of Etanercept in Rheumatoid Arthritis: An Analysis From the Gruppo Italiano di Studio sulla Early Arthritis (Italian Group for the Study of Early Arthritis) Registry

Sebastiani, M
Conceptualization
;
Manfredi, A
Writing – Review & Editing
;
Cassone, G
Membro del Collaboration Group
;
2020-01-01

Abstract

Objectives: This study aims to investigate the factors associated with early discontinuation (within one year) of etanercept (ETA) in rheumatoid arthritis (RA) patients who began ETA as first biologic disease-modifying antirheumatic drug (bDMARD) and who were entered into the Gruppo Italiano di Studio sulla Early Arthritis (Italian Group for the Study of Early Arthritis; GISEA) registry.Patients and methods: This registry-based cohort study included 477 RA patients (95 males, 382 females; median age 53 years; range 18 to 83 years) who began ETA as first bDMARD. Patient demographics, disease features and drugs were re-evaluated after 12 months. Baseline predictors of ETA discontinuation were estimated by univariate and multivariate analyses using Cox regression model.Results: Seventy patients (14.7%) discontinued ETA during the first year (for inefficacy in 55.8%, adverse events in 28.6%, and other reasons in 6.5%). Concurrent conventional synthetic DMARDs (csDMARDs) were reported in 54.3% of patients, mainly methotrexate (MTX), while 52.4% of subjects took low doses of glucocorticoids. Patients stopping ETA more frequently showed one or more comorbidities, mainly cardiovascular diseases (28.6% vs. 15.7% in patients stopping and continuing ETA, respectively, p=0.009). The presence of comorbidities and a combination therapy with csDMARDs other than MTX were independent factors associated with early discontinuation of ETA at multivariate Cox analysis.Conclusion: Although ETA demonstrated a high persistence in biologic-naive RA patients, about 15% of patients discontinued the treatment within 12 months. The presence of comorbidities and a combination therapy with csDMARDs other than MTX were the main factors for an early withdrawal of the drug.
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Factors Predicting Early Failure of Etanercept in Rheumatoid Arthritis: An Analysis From the Gruppo Italiano di Studio sulla Early Arthritis (Italian Group for the Study of Early Arthritis) Registry / Sebastiani, M; Manfredi, A; Iannone, F; Gremese, E; Bortoluzzi, A; Favalli, E; Bazzani, C; Salaffi, F; Fusaro, E; Foti, R; Giannitti, C; Caporali, R; Gauli, A; Cassone, G; Lopalco, G; Petricca, L; Ferraccioli, G; Lapadula, G. - In: ARCHIVES OF RHEUMATOLOGY. - ISSN 2148-5046. - 35:2(2020), pp. 163-169. [10.46497/ArchRheumatol.2020.7499]
Sebastiani, M; Manfredi, A; Iannone, F; Gremese, E; Bortoluzzi, A; Favalli, E; Bazzani, C; Salaffi, F; Fusaro, E; Foti, R; Giannitti, C; Caporali, R; Gauli, A; Cassone, G; Lopalco, G; Petricca, L; Ferraccioli, G; Lapadula, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1204644
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