Document Detail

Treatment patterns in the first year after initiating tumor necrosis factor blockers in real-world settings.
MedLine Citation:
PMID:  22886712     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Tumor necrosis factor (TNF)-blockers are approved for use in several immune-related conditions, but treatment patterns, such as switching between TNF blockers or restarting treatment after a gap in therapy, are not clearly established. This analysis examined TNF blocker treatment patterns within the first year after initiating treatment with etanercept, adalimumab, or infliximab in patients with rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis.
METHODS: Administrative claims data from the MarketScan® Commercial Claims and Encounters Database (Thomson Reuters, Ann Arbor, MI, USA) were analyzed for patients with rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis who were continuously enrolled and newly initiated etanercept, adalimumab, or infliximab treatment between January 1, 2005 and July 1, 2009. Persistence (no treatment gap ≥45 days), restarting index therapy (after a ≥45-day treatment gap), switching to a different biologic of interest (certolizumab, golimumab, ustekinumab, alefacept, abatacept, rituximab, or tocilizumab), and stopping (≥45-day treatment gap with no restart or switch) were analyzed for the first year after the index date.
RESULTS: A total of 8,454 patients had an index claim for etanercept (n = 4,224), adalimumab (n = 2,941), or infliximab (n = 1,289). Treatment patterns in the first year across all four conditions combined for etanercept, adalimumab, or infliximab, respectively, were: persistence, 42%, 47%, and 56%; restarting, 25%, 19%, and 12%; switching, 13%, 12%, and 13%; and stopping, 20%, 22%, and 19%. The combined rates of either persistence or restarting initial therapy after a treatment gap were 67%, 66%, and 68%, for etanercept, adalimumab, and infliximab, respectively. Most switches (66-92%) were between the three TNF blockers.
CONCLUSION: In the first year after initiating TNF blocker therapy, patients often have a ≥45-day treatment gap; however, approximately two-thirds of patients are either persistent with or restart their index therapy in the year following TNF blocker initiation.
Machaon Bonafede; Kathleen M Fox; Crystal Watson; Nicole Princic; Shravanthi R Gandra
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-08-08
Journal Detail:
Title:  Advances in therapy     Volume:  29     ISSN:  1865-8652     ISO Abbreviation:  Adv Ther     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-28     Completed Date:  2013-01-16     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  8611864     Medline TA:  Adv Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  664-74     Citation Subset:  T    
Thomson Reuters, 37 Lowell Street, Andover, MA, USA.
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MeSH Terms
Antibodies, Monoclonal / adverse effects,  therapeutic use
Antibodies, Monoclonal, Humanized / adverse effects,  therapeutic use*
Arthritis, Psoriatic / diagnosis,  drug therapy
Arthritis, Rheumatoid / diagnosis,  drug therapy
Cohort Studies
Databases, Factual
Dose-Response Relationship, Drug
Drug Administration Schedule
Follow-Up Studies
Immunoglobulin G / adverse effects,  therapeutic use
Insurance Claim Review
Middle Aged
Musculoskeletal Diseases / drug therapy*,  pathology
Patient Compliance / statistics & numerical data
Receptors, Tumor Necrosis Factor / therapeutic use
Retrospective Studies
Spondylitis, Ankylosing / diagnosis,  drug therapy
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
United States
Young Adult
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Immunoglobulin G; 0/Receptors, Tumor Necrosis Factor; 0/Tumor Necrosis Factor-alpha; 0/infliximab; 185243-69-0/TNFR-Fc fusion protein; FYS6T7F842/adalimumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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