Duration of Treatment With Etanercept and Motives for Discontinuation in a Cohort of Patients With Rheumatic Disease

• Published in: Reumatología clinica (Barcelona) 2011-11, Vol.7 (6), p.385-388
• Main Authors: Senabre-Gallego, José Miguel, Rosas-Gómez de Salazar, José, Santos-Soler, Gregorio, Santos-Ramírez, Carlos, Sánchez-Barrioluengo, Mabel, Salas-Heredia, Esteban, Barber-Vallés, Xavier, Cano-Pérez, Catalina, Llahí-Vidal, Núria, Riestra-Juán, Rosa
• Format: Article
• Language: English
• Subjects: Acontecimiento adverso; Adverse event; Artritis; Discontinuación; Drug discontinuations; Etanercept; Supervivencia; Survival; Terapia biológica
• ISSN: 2173-5743; 2173-5743
• DOI: 10.1016/j.reumae.2011.11.002

To evaluate the duration of etanercept (ETN) treatment and motives for discontinuation in our local cohort of patients with rheumatic pathology and compare them to the group with other biological treatments. Prospective observational cohort study. Disease diagnosis, start and end date and motive for discontinuation were recorded. Survival estimation was explored using Kaplan–Meier analysis with remaining patients censored at 1-year, 2-years and 5-years follow-up. Ninety-two (45%) out of 205 patients started ETN treatment. Disease diagnoses recorded were: 48% rheumatoid arthritis, 33% ankylosing spondylitis, 11% psoriatic arthritis, 8% others (juvenile idiopathic arthritis, inflammatory bowel disease related spondylitis, SAPHO syndrome). 52% of patients are still on the drug. The motives for discontinuation were: inefficacy (65%), adverse events (33%) and lack of compliance (2%). Two patients discontinued ETN due to prolonged disease control. Adverse events were: infection (4 patients), post-injection skin reaction (3), uveitis (3), neoplasia (2) and others (3). Using a Kaplan–Meier analysis, at 1-year 64% (CI95% 54–74) of patients with ETN treatment had not experienced treatment failure, at 2-years, 59% (48–69) and at 5-years, 43% (30–52). With the rest of biologicals estimated survival was 61% (51–68), 47.5% (40–55), and 23% (10.5–32), respectively. Statistical analysis revealed significant differences (log-rank: P=.024; Breslow: P=.068; Tarone-Ware: P=.040). In our cohort of patients treated with ETN the estimated survival was better than patients treated with other biological drugs at 1-year, 2-years and 5-years. Evaluar la supervivencia del tratamiento con etanercept (ETN) y las causas de discontinuación en una cohorte local de pacientes en tratamiento biológico (TB). Comparar con la supervivencia general del resto de TB. Estudio observacional prospectivo de cohortes. Se han analizado los datos de diagnóstico, fecha de inicio y fin de tratamiento, así como la causa de interrupción de nuestro registro de TB. Mediante el método de Kaplan–Meier se ha estimado la supervivencia de ETN al año, a los 2 años y a los 5 años. De un total de 205 pacientes que recibieron TB, 92 (45%) iniciaron tratamiento con ETN. En el 48% el diagnóstico fue artritis reumatoide, 33% espondilitis anquilosante, 11% artritis psoriásica y 8% otros diagnósticos (artritis idiopática juvenil, espondiloartritis asociada a enfermedad inflamatoria intestinal y síndrome SAPHO). Continúan co