Presentation: Direct Comparison of 4 Years' Drug Survival of Adalimumab, Etanercept and Infliximab in Rheumatoid Arthritis Patients. An Observational Study From the DANBIO Registry (ACR/ARHP Annual Scientific Meeting)

Start | Author Index | Keyword Index | Itinerary Builder | ACR Home Page | Annual Meeting Page

997 - Direct Comparison of 4 Years' Drug Survival of Adalimumab, Etanercept and Infliximab in Rheumatoid Arthritis Patients. An Observational Study From the DANBIO Registry

Monday, October 19, 2009: 9:00 AM - 11:00 AM
Hall D (Pennsylvania Convention Center)
M.L. Hetland1, I.J. Christensen2, U. Tarp3, L. Dreyer1, A. Hansen1, I.T. Hansen1, G. Kollerup1, L. Linde1, H.M. Lindegaard1, U.E. Poulsen1, A. Schlemmer1, D.V. Jensen1, S. Jensen1 and M. Østergaard1, 1DANBIO, On behalf of Depts of Rheumatology, North, South, Central, Sealand and Capital Region, Copenhagen, Denmark, 2Copenhagen, Denmark, 3DANBIO, Copenhagen, Denmark
Presentation Number: 997
Poster Board Number: 348

Purpose: Data on the withdrawal rates of different TNF-inhibitors (TNF-I) in clinical practice are scarce. The aim was to determine 4-year drug survival of the different TNF-I and calculate Hazard Ratios (HRs) of their withdrawal based on the DANBIO registry.
Methods: 2935 RA patients (832 (28%) adalimumab, 703 (24%) etanercept, 1400 (48%) infliximab) were followed from start of first TNF-I treatment to withdrawal of treatment or Oct 1st 2008 (whichever came first). HRs were calculated correcting for baseline disease activity, age, disease duration, concomitant methotrexate and prednisolone, number of previous DMARDs, HAQ score and hospital department. Propensity scores and various subanalyses gave similar results, not shown.
Results: Figure shows 4 years' (unadjusted) drug survival: adalimumab:56%(95%CI:51-61%); etanercept:63%(58-68%); infliximab:44%(41-47%), p<0.0001, log rank test.
Below the figure, numbers of events and numbers of patients at risk at different time points for each drug are shown.
HRs for drug withdrawal, incl. subanalyses by reason for withdrawal, are shown in table.
Table:

Hazard Ratios (95% CI) for drug withdrawal

 

Adalimumab vs. etanercept

Infliximab vs. etanercept

Infliximab vs. adalimumab

All pts (1099 events)

1.56 (1.26-1.94)

2.10 (1.70-2.59

1.35 (1.13-1.61)

LOE (727 events)

1.51 (1.17-1.96)

1.73 (1.35-2.23)

1.15 (0.92-1.42)

AE (327 events)

1.73 (1.14-2.62)

3.19 (2.15-4.72)

1.85 (1.35-2.52)

LOE: lack of efficacy; AE: adverse event


Conclusion: In this nationwide follow-up study of 2935 RA patients, 4 years' drug survival was highest for etanercept. After correcting for differences in baseline characteristics, the hazard ratio for withdrawal was overall highest for infliximab and lowest for etanercept regardless of reason for withdrawal.
Disclosure of Interest: The DANBIO registry received unrestricted grants from Abbott, BMS, Roche, Schering-Plough, UCB Nordic and Wyeth.


Keywords: anti-TNF therapy and rheumatoid arthritis (RA)

Disclosure: M. L. Hetland, Abbott Laboratories, 5, Centocor, Inc., 2, Roche Pharmaceuticals, 2, Schering-Plough, 5, UCB Nordic, 5, Wyeth Pharmaceuticals, 5 ; I. J. Christensen, None; U. Tarp, Roche Pharmaceuticals, 5, Abbott Laboratories, 5 ; L. Dreyer, None; A. Hansen, Abbott Laboratories, 5, Wyeth Pharmaceuticals, 5, Schering-Plough, 5 ; I. T. Hansen, None; G. Kollerup, Abbott Immunology Pharmaceuticals, 5 ; L. Linde, None; H. M. Lindegaard, Roche Pharmaceuticals, 5, Abbott Immunology Pharmaceuticals, 5, Schering-Plough, 5, Bristol-Myers Squibb, 5 ; U. E. Poulsen, None; A. Schlemmer, Schering-Plough, 5 ; D. V. Jensen, Wyeth Pharmaceuticals, 5 ; S. Jensen, None; M. Østergaard, Centocor, Inc., 2, Schering-Plough, 5, Abbott Laboratories, 5, Wyeth Pharmaceuticals, 5 .
<< Previous Abstract in Session | Next Abstract in Session >>
See more of: Rheumatoid Arthritis Treatment: Strategies and Outcomes
See more of: ACR Poster Sessions