Long-term drug survival and causes of discontinuation of subcutaneous abatacept in rheumatoid arthritis: 32-month results from a prospective cohort study

Background Survival time or time to discontinuation of medication is a surrogate of the long-term impact on the course of disease in real life. It reflects clinical effectiveness in the absence of significant adverse events [1]. Treatment discontinuation can result from loss of efficacy or safety co...

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Fecha de publicación:
2017
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/28079
Acceso en línea:
https://repository.urosario.edu.co/handle/10336/28079
Palabra clave:
Long-term
Survival of subcutaneous
Rheumatoid arthritis
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id EDOCUR2_e3a31dc76e63a08324e331698dc4d949
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network_acronym_str EDOCUR2
network_name_str Repositorio EdocUR - U. Rosario
repository_id_str
spelling 3e8ff7f8-f1ed-41bd-acea-4b8a86b1e1c180873475600517994996007ba3a914-410e-48b9-be8f-11061dd324742020-08-19T14:45:38Z2020-08-19T14:45:38Z2017-06-17Background Survival time or time to discontinuation of medication is a surrogate of the long-term impact on the course of disease in real life. It reflects clinical effectiveness in the absence of significant adverse events [1]. Treatment discontinuation can result from loss of efficacy or safety concerns, but prognostic factors for patient retention have not been explored thoroughly despite data for abatacept and other biologics being available from national registries [2]. Objectives To assess drug survival of subcutaneous (SC) abatacept among patients with rheumatoid arthritis (RA) according to treatment background. Methods This was a prospective study in which well-characterized patients with RA (by 1987 ACR criteria) were assessed from April 2014 to December 2016. Each patient was evaluated by a rheumatologist in a single rheumatology outpatient private center in Bogotá, Colombia. Patients were stratified by treatment background: (n=54) biologic-naïve, (n=24) switched from IV to SC abatacept administration, and (n=51) inadequate response to at least 1 biologic disease-modifying antirheumatic drug. The Mantel-Haenszel test was used to test if there were any differences in the survival curves among groups. The test was performed by the survdiff function of the “survival” R package [3]. Results A total of 129 patients were included. Baseline characteristics of patients were as follows: female gender 86%, mean age 52±13 years, median disease duration 10 (IQR 11) years, Rheumatoid Factor positive 94%, Anti-Cyclic Citrullinated Peptide Antibodies 89%, and erosive phenotype 35%. At baseline, mean DAS28 and RAPID3 were 5.4±1.3 and 16.6±6.8, respectively. SC abatacept monotherapy was reported in 27%. Demographics and disease characteristics were similar in all groups, except for baseline DAS28 and RAPID3 in switch group (p<0.0001). According to the Mantel-Haenszel test (Fig.1), there were not significant differences between survival curves (p=0.158). Forty-three patients (33%) discontinued treatment. The most frequent reasons for drug suspension were loss of efficacy in 25%, insurance-related problems (i.e., access to medication/specialist) and adverse drug reactions in 16%. Other causes include lack of efficacy, surgeries (i.e., articular replacement), patient preference, and pregnancy.application/pdfISSN: 0003-4967EISSN: 1468-2060https://repository.urosario.edu.co/handle/10336/28079engEuropean League Against RheumatismBMJ PublishingNo. 2850Annals of the Rheumatic DiseasesVol. 76Annals of the Rheumatic Diseases, ISSN: 0003-4967;EISSN: 1468-2060, Vol.76, Suppl No.2 (2017); pp. 850Scientific Abstracts; pp. SAT0205https://ard.bmj.com/content/annrheumdis/76/Suppl_2/850.2.full.pdfAbierto (Texto Completo)http://purl.org/coar/access_right/c_abf2Annals of the Rheumatic Diseasesinstname:Universidad del Rosarioreponame:Repositorio Institucional EdocURLong-termSurvival of subcutaneousRheumatoid arthritisLong-term drug survival and causes of discontinuation of subcutaneous abatacept in rheumatoid arthritis: 32-month results from a prospective cohort studySupervivencia del fármaco a largo plazo y causas de interrupción del abatacept subcutáneo en la artritis reumatoide: resultados a 32 meses de un estudio de cohorte prospectivoarticleArtículohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_6501Sarmiento-Monroy, JCMolano González, NicolásRodríguez Jiménez, Mónica María del PilarMantilla, RD10336/28079oai:repository.urosario.edu.co:10336/280792021-10-15 06:23:17.618https://repository.urosario.edu.coRepositorio institucional EdocURedocur@urosario.edu.co
dc.title.spa.fl_str_mv Long-term drug survival and causes of discontinuation of subcutaneous abatacept in rheumatoid arthritis: 32-month results from a prospective cohort study
dc.title.TranslatedTitle.spa.fl_str_mv Supervivencia del fármaco a largo plazo y causas de interrupción del abatacept subcutáneo en la artritis reumatoide: resultados a 32 meses de un estudio de cohorte prospectivo
title Long-term drug survival and causes of discontinuation of subcutaneous abatacept in rheumatoid arthritis: 32-month results from a prospective cohort study
spellingShingle Long-term drug survival and causes of discontinuation of subcutaneous abatacept in rheumatoid arthritis: 32-month results from a prospective cohort study
Long-term
Survival of subcutaneous
Rheumatoid arthritis
title_short Long-term drug survival and causes of discontinuation of subcutaneous abatacept in rheumatoid arthritis: 32-month results from a prospective cohort study
title_full Long-term drug survival and causes of discontinuation of subcutaneous abatacept in rheumatoid arthritis: 32-month results from a prospective cohort study
title_fullStr Long-term drug survival and causes of discontinuation of subcutaneous abatacept in rheumatoid arthritis: 32-month results from a prospective cohort study
title_full_unstemmed Long-term drug survival and causes of discontinuation of subcutaneous abatacept in rheumatoid arthritis: 32-month results from a prospective cohort study
title_sort Long-term drug survival and causes of discontinuation of subcutaneous abatacept in rheumatoid arthritis: 32-month results from a prospective cohort study
dc.subject.keyword.spa.fl_str_mv Long-term
Survival of subcutaneous
Rheumatoid arthritis
topic Long-term
Survival of subcutaneous
Rheumatoid arthritis
description Background Survival time or time to discontinuation of medication is a surrogate of the long-term impact on the course of disease in real life. It reflects clinical effectiveness in the absence of significant adverse events [1]. Treatment discontinuation can result from loss of efficacy or safety concerns, but prognostic factors for patient retention have not been explored thoroughly despite data for abatacept and other biologics being available from national registries [2]. Objectives To assess drug survival of subcutaneous (SC) abatacept among patients with rheumatoid arthritis (RA) according to treatment background. Methods This was a prospective study in which well-characterized patients with RA (by 1987 ACR criteria) were assessed from April 2014 to December 2016. Each patient was evaluated by a rheumatologist in a single rheumatology outpatient private center in Bogotá, Colombia. Patients were stratified by treatment background: (n=54) biologic-naïve, (n=24) switched from IV to SC abatacept administration, and (n=51) inadequate response to at least 1 biologic disease-modifying antirheumatic drug. The Mantel-Haenszel test was used to test if there were any differences in the survival curves among groups. The test was performed by the survdiff function of the “survival” R package [3]. Results A total of 129 patients were included. Baseline characteristics of patients were as follows: female gender 86%, mean age 52±13 years, median disease duration 10 (IQR 11) years, Rheumatoid Factor positive 94%, Anti-Cyclic Citrullinated Peptide Antibodies 89%, and erosive phenotype 35%. At baseline, mean DAS28 and RAPID3 were 5.4±1.3 and 16.6±6.8, respectively. SC abatacept monotherapy was reported in 27%. Demographics and disease characteristics were similar in all groups, except for baseline DAS28 and RAPID3 in switch group (p<0.0001). According to the Mantel-Haenszel test (Fig.1), there were not significant differences between survival curves (p=0.158). Forty-three patients (33%) discontinued treatment. The most frequent reasons for drug suspension were loss of efficacy in 25%, insurance-related problems (i.e., access to medication/specialist) and adverse drug reactions in 16%. Other causes include lack of efficacy, surgeries (i.e., articular replacement), patient preference, and pregnancy.
publishDate 2017
dc.date.created.spa.fl_str_mv 2017-06-17
dc.date.accessioned.none.fl_str_mv 2020-08-19T14:45:38Z
dc.date.available.none.fl_str_mv 2020-08-19T14:45:38Z
dc.type.eng.fl_str_mv article
dc.type.coarversion.fl_str_mv http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_6501
dc.type.spa.spa.fl_str_mv Artículo
dc.identifier.issn.none.fl_str_mv ISSN: 0003-4967
EISSN: 1468-2060
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/28079
identifier_str_mv ISSN: 0003-4967
EISSN: 1468-2060
url https://repository.urosario.edu.co/handle/10336/28079
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.citationIssue.none.fl_str_mv No. 2
dc.relation.citationStartPage.none.fl_str_mv 850
dc.relation.citationTitle.none.fl_str_mv Annals of the Rheumatic Diseases
dc.relation.citationVolume.none.fl_str_mv Vol. 76
dc.relation.ispartof.spa.fl_str_mv Annals of the Rheumatic Diseases, ISSN: 0003-4967;EISSN: 1468-2060, Vol.76, Suppl No.2 (2017); pp. 850
Scientific Abstracts; pp. SAT0205
dc.relation.uri.spa.fl_str_mv https://ard.bmj.com/content/annrheumdis/76/Suppl_2/850.2.full.pdf
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.acceso.spa.fl_str_mv Abierto (Texto Completo)
rights_invalid_str_mv Abierto (Texto Completo)
http://purl.org/coar/access_right/c_abf2
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.spa.fl_str_mv European League Against Rheumatism
BMJ Publishing
dc.source.spa.fl_str_mv Annals of the Rheumatic Diseases
institution Universidad del Rosario
dc.source.instname.none.fl_str_mv instname:Universidad del Rosario
dc.source.reponame.none.fl_str_mv reponame:Repositorio Institucional EdocUR
repository.name.fl_str_mv Repositorio institucional EdocUR
repository.mail.fl_str_mv edocur@urosario.edu.co
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