Evidence map›Paper›PMID 26917952›Full record

ArticlePatient preference and adherence2016

Is drug discontinuation risk of adalimumab compared with etanercept affected by concomitant methotrexate dose in patients with rheumatoid arthritis?

Hsin-Hua Chen, Der-Yuan Chen, Yi-Ming Chen, Chao-Hsiun Tang

Open access · goldAbstract read
In one paragraph

Article in Patient preference and adherence, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 36% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
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

4 authors at 3 institutions in 1 country.

Hsin-Hua ChenDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China; School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China; Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taiwan, Republic of China; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan, Republic of China; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan, Republic of China.
Der-Yuan ChenDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China; School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China; Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan, Republic of China; Institute of Biomedical Science, Chung-Hsing University, Taichung, Taiwan, Republic of China; Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
Yi-Ming ChenDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China; School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China; Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
Chao-Hsiun TangSchool of Health Care Administration, Taipei Medical University, Taipei, Taiwan, Republic of China.
Chung Shan Medical University · TWNational Yang Ming University Hospital · TWTaichung Veterans General Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare drug discontinuation risk between adalimumab (ADA) and etanercept (ETN) treatment among anti-tumor necrosis factor (anti-TNF)-naïve rheumatoid arthritis (RA) patients, in particular the influence of concomitant dose of methotrexate (MTX).

methodsThis retrospective nationwide population-based cohort study identified 4,592 anti-TNF-naïve RA patients in whom ETN (n=2,609) or ADA (n=1,983) was initiated using National Health Insurance claims data. After adjustment for prior medication, concomitant medication, and baseline demographic data, the relative risk of drug discontinuation in ADA users compared with ETN users was quantified by calculating adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) using Cox proportional hazard regression analyses, stratified by the follow-up time (≤1 year, >1 year) and/or concomitant MTX dose (≤10 mg/wk, >10 mg/wk).

resultsADA users had a higher risk of drug discontinuation compared with ETN users during the first year of follow-up (aHR, 1.13; 95% CI, 1.01-1.27), but not during all treatment periods (aHR, 1.06; 95% CI, 0.98-1.16) or after 1 year (aHR, 0.99; 95% CI, 0.87-1.13). However, ADA users had a significantly higher risk of drug discontinuation compared with ETN users among patients on concomitant MTX >10 mg/wk during all treatment periods (aHR, 1.27; 95% CI, 1.10-1.47), during the first year of follow-up (aHR, 1.48; 95% CI, 1.22-1.78), or after 1 year (aHR, 1.42; 95% CI, 1.06-1.90), but not among patients on concomitant MTX 0-10 mg/wk.

conclusionThis population-based cohort study demonstrated a modification effect of concomitant MTX dose on the relative risk of anti-TNF discontinuation for ADA compared with ETN among anti-TNF-naïve RA patients. However, the lack of exact cause of anti-TNF discontinuation limited causal inference of such a concomitant MTX dose-related modification effect.

Indexed as

adalimumabetanerceptmethotrexaterheumatoid arthritistreatment discontinuation

Identifiers

PMID26917952
PMCPMC4751906
OpenAlexW2270875773

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.