Evidence map›Paper›PMID 39392514›Full record

ArticleClinical rheumatology2024

Incidence and risk factors of discontinuation of tofacitinib and biologic disease-modifying anti-rheumatic drugs among patients with rheumatoid arthritis: A population-based cohort study.

Po-Cheng Shih, Po-Cheng Hung, Pui-Ying Leong, Jui-Ning Hsu, Chieh-Chun Yang, James Cheng Chung Wei, Hsin-Hua Chen

Abstract read
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In one paragraph

Article in Clinical rheumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Article
  4. Review
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

7 authors.

Po-Cheng ShihDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Changhua Christian Hospital, No. 135, NanXiao Street, Changhua, 500, Taiwan. robertpcshih@gmail.com.ORCID http://orcid.org/0000-0003-4152-9296
Po-Cheng HungSchool of Medicine, Chung Shan Medical University, Taichung, 402, Taiwan.
Pui-Ying LeongInstitute of Medicine, Chung Shan Medical University, South District, No. 110, Sec. 1, Jianguo N. Rd., Taichung, 40201, Taiwan.
Jui-Ning HsuSchool of Medicine, Chung Shan Medical University, Taichung, 402, Taiwan.
Chieh-Chun YangSchool of Medicine, Chung Shan Medical University, Taichung, 402, Taiwan.
James Cheng Chung WeiInstitute of Medicine, Chung Shan Medical University, South District, No. 110, Sec. 1, Jianguo N. Rd., Taichung, 40201, Taiwan. jccwei@gmail.com.
Hsin-Hua ChenDivision of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Xitun District, No. 1650, Sec. 4, Taiwan Blvd., Taichung, 40705, Taiwan. shc5555@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To investigate the incidence of the discontinuation among tofacitinib and biologic disease-modifying anti-rheumatic drugs (bDMARDs) in patients with rheumatoid arthritis (RA). This retrospective population-based cohort study included 5,008 RA patients who initiated treatment with either tofacitinib or bDMARDs (etanercept, adalimumab, golimumab, tocilizumab, or abatacept) between January 1, 2014, and December 31, 2020. We conducted Cox proportional hazards regression and subsequent time-dependent regression to assess the risk of drug discontinuation, with adjustments for potential variables. The highest drug discontinuation rate was observed with etanercept (43.27%), while the lowest was with tofacitinib (21.8%). Tofacitinib was associated with a significantly lower risk of discontinuation compared to etanercept (HR: 0.67, 95% CI: 0.57-0.80) and other bDMARDs. Higher steroid dosage and the presence of concomitant connective tissue diseases were significant risk factors for drug discontinuation. Conversely, the use of methotrexate was associated with a reduced risk of discontinuation. Tofacitinib demonstrated a lower risk of drug discontinuation compared to TNFi, with the risk factors for discontinuation including higher steroid dosage and concomitant connective tissue diseases. The study highlights the importance of considering several potential risk factors in drug discontinuation. Key Points • Non-TNFi biologic agents demonstrated better drug retention than TNFi among patients diagnosed with rheumatoid arthritis, with tofacitinib showing the lowest discontinuation rate (21.8%), underscoring its potential for superior drug retention in rheumatoid arthritis management. • Several factors were associated with drug discontinuation: higher steroid dosage and concomitant connective tissue diseases were linked to a higher discontinuation rate, whereas the concomitant use of methotrexate was associated with a lower risk of discontinuation.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidPiperidinesPyrimidinesAbataceptAdalimumabAdultAgedBiological ProductsEtanerceptFemaleHumansIncidenceMaleMethotrexateMiddle AgedAbataceptAdalimumabAntirheumatic AgentsBiological ProductsEtanerceptMethotrexatePiperidinesPyrimidinestofacitinibBiological agentsDrug discontinuationDrug persistenceRheumatoid arthritisTNF inhibitorsTofacitinib

Identifiers

PMID39392514

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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.