Evidence map›Paper›PMID 26629366›Full record

ArticleRMD open2015

Discontinuation rates of biologics in patients with rheumatoid arthritis: are TNF inhibitors different from non-TNF inhibitors?

Sofia Ramiro, Robert Landewé, Désirée van der Heijde, David Harrison, David Collier, Kaleb Michaud

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in RMD open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
3.5field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Sofia RamiroDepartment of Clinical Immunology & Rheumatology , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands ; Department of Rheumatology , Hospital Garcia de Orta , Almada , Portugal.
Robert LandewéDepartment of Clinical Immunology & Rheumatology , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands ; Department of Rheumatology , Atrium Medical Center , Heerlen , The Netherlands.
Désirée van der HeijdeDepartment of Rheumatology , Leiden University Medical Center , Leiden , The Netherlands.
David HarrisonAmgen Inc. , Thousand Oaks, California , USA.
David CollierAmgen Inc. , Thousand Oaks, California , USA.
Kaleb MichaudNational Data Bank for Rheumatic Diseases , Wichita, Kansas , USA ; University of Nebraska Medical Center , Omaha, Nebraska , USA.
Amgen (United States) · USAmsterdam UMC Location University of Amsterdam · NLLeiden University Medical Center · NLThe National Databank for Rheumatic Diseases · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare discontinuation rates of first and second biologics in rheumatoid arthritis (RA) by tumour-necrosis factor inhibitor (TNFi) status and identify predictors and reasons for discontinuation.

methodsFrom 1998 to 2011, self-reported medication use for RA was assessed every 6 months via questionnaire in a longitudinal study in the USA. Time-on-drug analyses were conducted for individual biologics and groups, and annual rates reported. Time to discontinuation of TNFi and non-TNFi was compared, unadjusted and adjusted using propensity score analyses. Baseline and time-varying predictors of biologic discontinuation were derived through Cox regression.

resultsOf 2281 patients initiating their first biologic, 1100 (48%) discontinued and of 1097 initiating a second biologic, 537 (49%) discontinued. The annual discontinuation rate was 17% (median 4 years) for first biologic and 20% (median 3.3 years) for second biologic. TNFi had lower discontinuation rates than non-TNFi after propensity score adjustment: HR for first biologic 0.49 (0.34 to 0.71) and 0.68 (0.51 to 0.90) for second biologic. The annual discontinuation rate was significantly lower in patients starting their first biologic before January 2005 vs after (16 vs 25%, p=0.005). Predictors of discontinuation for the first biologic included smoking, higher comorbidity index, worse overall health and not using concomitant methotrexate.

conclusionsIn this large cohort, patients with RA tended to remain on their first and second biologics for relatively long periods suggesting the drugs' effectiveness. Discontinuation rates were lower in patients using TNFi, and all rates increased after January 2005 when the number of biologics available increased.

Indexed as

Anti-TNFDMARDs (biologic)Outcomes researchRheumatoid Arthritis

Identifiers

PMID26629366
PMCPMC4654098
OpenAlexW2285407069

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.