Comparison of the efficacy and risk of discontinuation between non-TNF-targeted treatment and a second TNF inhibitor in patients with rheumatoid arthritis after first TNF inhibitor failure
DC Field | Value | Language |
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dc.contributor.author | Park, Dong-Jin | - |
dc.contributor.author | Choi, Sung-Eun | - |
dc.contributor.author | Kang, Ji-Hyoun | - |
dc.contributor.author | Shin, Kichul | - |
dc.contributor.author | Sung, Yoon-Kyoung | - |
dc.contributor.author | Lee, Shin-Seok | - |
dc.date.accessioned | 2022-07-06T05:15:25Z | - |
dc.date.available | 2022-07-06T05:15:25Z | - |
dc.date.created | 2022-06-03 | - |
dc.date.issued | 2022-04 | - |
dc.identifier.issn | 1759-720X | - |
dc.identifier.uri | https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/138819 | - |
dc.description.abstract | Objectives: Despite improved care for rheumatoid arthritis (RAI patients, many still experience treatment failure with biologic disease-modifying antirheumatic drugs (bDMARDs) or targeted synthetic DMARDs [tsDMARDs; typically Janus kinase inhibitors (JAKi)], and eventually switch to other agents. We compared the efficacy of a second tumor necrosis factor inhibitor (TNFi) and non-TNF-targeted treatment as the second-line treatment in patients showing an insufficient response to the first TNFi. Methods: Patients were included if they had received at least one prescription for a TNFi, and at least one follow-up prescription for a second TNFi or non-TNF-targeted treatment after discontinuation of the first drug. In total, 209 patients were analyzed, including 69 with a second TNFi and 140 with a non-TNF-targeted treatment (106 non-TNFi biologics and 34 JAKi). Cox regression was used to estimate the hazard ratio (HR) for discontinuation. Results: The mean follow-up period after switching was 28.0 (range: 0-80) months and 24.4% of the 209 patients switched or discontinued the second drug. In multivariate Cox proportional hazard analysis, the non-TNF-targeted treatment group had a lower likelihood of discontinuing their treatment than the second TNFi group [HR=0.326, 95% confidence interval (CI): 0.170-0.626, p=0.001]. When analyzed separately, the risk of discontinuation was significantly lower in both the non-TNFi biologic (HR=0.318, 95% CI: 0.160-0.633, p=0.001) and JAKi (HR= 0.356, 95% CI: 0.129-0.980, p=0.046) groups than in the second TNFi group. Conclusion: Our study supported switching to a non-TNF-targeted treatment instead of TNF cycling in patients with RA showing an inadequate response to initial TNFi. Results: The mean follow-up period after switching was 28.0 (range: 0–80) months and 24.4% of the 209 patients switched or discontinued the second drug. In multivariate Cox proportional hazard analysis, the non-TNF-targeted treatment group had a lower likelihood of discontinuing their treatment than the second TNFi group [HR = 0.326, 95% confidence interval (CI): 0.170–0.626, p = 0.001]. When analyzed separately, the risk of discontinuation was significantly lower in both the non-TNFi biologic (HR = 0.318, 95% CI: 0.160–0.633, p = 0.001) and JAKi (HR = 0.356, 95% CI: 0.129–0.980, p = 0.046) groups than in the second TNFi group. Conclusion: Our study supported switching to a non-TNF-targeted treatment instead of TNF cycling in patients with RA showing an inadequate response to initial TNFi. | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | SAGE PUBLICATIONS LTD | - |
dc.title | Comparison of the efficacy and risk of discontinuation between non-TNF-targeted treatment and a second TNF inhibitor in patients with rheumatoid arthritis after first TNF inhibitor failure | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Sung, Yoon-Kyoung | - |
dc.identifier.doi | 10.1177/1759720X221091450 | - |
dc.identifier.scopusid | 2-s2.0-85128624821 | - |
dc.identifier.wosid | 000786422500001 | - |
dc.identifier.bibliographicCitation | THERAPEUTIC ADVANCES IN MUSCULOSKELETAL DISEASE, v.14, pp.1 - 15 | - |
dc.relation.isPartOf | THERAPEUTIC ADVANCES IN MUSCULOSKELETAL DISEASE | - |
dc.citation.title | THERAPEUTIC ADVANCES IN MUSCULOSKELETAL DISEASE | - |
dc.citation.volume | 14 | - |
dc.citation.startPage | 1 | - |
dc.citation.endPage | 15 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.isOpenAccess | Y | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Rheumatology | - |
dc.relation.journalWebOfScienceCategory | Rheumatology | - |
dc.subject.keywordPlus | ANTITUMOR NECROSIS FACTOR | - |
dc.subject.keywordPlus | DISEASE-ACTIVITY | - |
dc.subject.keywordPlus | METHOTREXATE THERAPY | - |
dc.subject.keywordPlus | CLINICAL-OUTCOMES | - |
dc.subject.keywordPlus | BIOLOGIC THERAPY | - |
dc.subject.keywordPlus | TOCILIZUMAB | - |
dc.subject.keywordPlus | ABATACEPT | - |
dc.subject.keywordPlus | ASSOCIATION | - |
dc.subject.keywordPlus | MULTICENTER | - |
dc.subject.keywordPlus | CONCOMITANT | - |
dc.subject.keywordAuthor | JAK inhibitor | - |
dc.subject.keywordAuthor | rheumatoid arthritis | - |
dc.subject.keywordAuthor | switching | - |
dc.subject.keywordAuthor | treatment continuation | - |
dc.subject.keywordAuthor | TNF inhibitor | - |
dc.identifier.url | https://journals.sagepub.com/doi/10.1177/1759720X221091450 | - |
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