Discontinuation of anti-TNF-α therapy in a Chinese cohort of patients with rheumatoid arthritis
Identifieur interne : 001403 ( Main/Exploration ); précédent : 001402; suivant : 001404Discontinuation of anti-TNF-α therapy in a Chinese cohort of patients with rheumatoid arthritis
Auteurs : Cheng-Tao Yang [Taïwan] ; Chang-Fu Kuo [Taïwan] ; Shue-Fen Luo [Taïwan] ; Kuang-Hui Yu [Taïwan]Source :
- Clinical Rheumatology [ 0770-3198 ] ; 2012-11-01.
English descriptors
Abstract
Abstract: The aim of this retrospective study was to examine the predictors of discontinuation of anti-tumor necrosis factor (TNF) therapy due to adverse events in Chinese patients with rheumatoid arthritis (RA). Anti-TNF-related adverse events were recorded and analyzed in 217 consecutive patients with RA followed in our institution from 2003 to 2010. Time to discontinuation of anti-TNF-α therapy was estimated using survival analysis techniques. The anti-TNF agents administered were etanercept in 181 patients and adalimumab in 36 patients. The mean age at diagnosis was 45.2 ± 13.5 years, and mean age at initiation of anti-TNF therapy was 51.8 ± 13.0 years. The mean duration of anti-TNF agent use was 36.0 ± 26.5 months (range, 1.4–87.0; median, 26.4 months). Of the 217 patients, 39 (18.0 %) developed adverse events [etanercept in 34 (18.8 %] and adalimumab in 5 (13.9 %)] during the treatment period (tuberculosis in 5, bacterial infections in 19, virus infection in 7, neuropathy in 3, malignancy in 3, other drug-related events in 1, and appendicitis in 1). In patients with RA, older age (≥55 years) at initiation of anti-TNF therapy [odds ratio (OR), 3.20; 95 % confidence interval (CI), 1.67–6.20; p < 0.001], Cr ≥1.5 mg/dL (OR, 5.72; 95 % CI, 1.17–27.90; p = 0.031), and occurrence of adverse events (OR, 3.82; 95 % CI, 1.75–8.35; p = 0.001) were associated with increased likelihood of discontinuation of anti-TNF treatment. In the present study, a significant proportion (7.8 %, 17/217) of patients with RA discontinued anti-TNF treatment because of adverse events. In the elderly and in patients with renal insufficiency, caution is needed when starting anti-TNF treatment.
Url:
DOI: 10.1007/s10067-012-2047-8
Affiliations:
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International League of Associations for Rheumatology</title><title level="j" type="abbrev">Clin Rheumatol</title><idno type="ISSN">0770-3198</idno><idno type="eISSN">1434-9949</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>London</pubPlace><date type="published" when="2012-11-01">2012-11-01</date><biblScope unit="volume">31</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1549">1549</biblScope><biblScope unit="page" to="1557">1557</biblScope></imprint><idno type="ISSN">0770-3198</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0770-3198</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adverse event</term><term>Infection</term><term>Rheumatoid arthritis</term><term>Tumor necrosis factor</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: The aim of this retrospective study was to examine the predictors of discontinuation of anti-tumor necrosis factor (TNF) therapy due to adverse events in Chinese patients with rheumatoid arthritis (RA). Anti-TNF-related adverse events were recorded and analyzed in 217 consecutive patients with RA followed in our institution from 2003 to 2010. Time to discontinuation of anti-TNF-α therapy was estimated using survival analysis techniques. The anti-TNF agents administered were etanercept in 181 patients and adalimumab in 36 patients. The mean age at diagnosis was 45.2 ± 13.5 years, and mean age at initiation of anti-TNF therapy was 51.8 ± 13.0 years. The mean duration of anti-TNF agent use was 36.0 ± 26.5 months (range, 1.4–87.0; median, 26.4 months). Of the 217 patients, 39 (18.0 %) developed adverse events [etanercept in 34 (18.8 %] and adalimumab in 5 (13.9 %)] during the treatment period (tuberculosis in 5, bacterial infections in 19, virus infection in 7, neuropathy in 3, malignancy in 3, other drug-related events in 1, and appendicitis in 1). In patients with RA, older age (≥55 years) at initiation of anti-TNF therapy [odds ratio (OR), 3.20; 95 % confidence interval (CI), 1.67–6.20; p < 0.001], Cr ≥1.5 mg/dL (OR, 5.72; 95 % CI, 1.17–27.90; p = 0.031), and occurrence of adverse events (OR, 3.82; 95 % CI, 1.75–8.35; p = 0.001) were associated with increased likelihood of discontinuation of anti-TNF treatment. In the present study, a significant proportion (7.8 %, 17/217) of patients with RA discontinued anti-TNF treatment because of adverse events. In the elderly and in patients with renal insufficiency, caution is needed when starting anti-TNF treatment.</div></front></TEI><affiliations><list><country><li>Taïwan</li></country></list><tree><country name="Taïwan"><noRegion><name sortKey="Yang, Cheng Tao" sort="Yang, Cheng Tao" uniqKey="Yang C" first="Cheng-Tao" last="Yang">Cheng-Tao Yang</name></noRegion><name sortKey="Kuo, Chang Fu" sort="Kuo, Chang Fu" uniqKey="Kuo C" first="Chang-Fu" last="Kuo">Chang-Fu Kuo</name><name sortKey="Luo, Shue Fen" sort="Luo, Shue Fen" uniqKey="Luo S" first="Shue-Fen" last="Luo">Shue-Fen Luo</name><name sortKey="Yu, Kuang Hui" sort="Yu, Kuang Hui" uniqKey="Yu K" first="Kuang-Hui" last="Yu">Kuang-Hui Yu</name><name sortKey="Yu, Kuang Hui" sort="Yu, Kuang Hui" uniqKey="Yu K" first="Kuang-Hui" last="Yu">Kuang-Hui Yu</name><name sortKey="Yu, Kuang Hui" sort="Yu, Kuang Hui" uniqKey="Yu K" first="Kuang-Hui" last="Yu">Kuang-Hui Yu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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