Background and importance Rheumatoid arthritis is a chronic, autoimmune disease, with unknown aetiology, characterised by chronic inflammation of synovial articulations. Biologic disease modifying antirheumatic drugs (bDMARDs) are used to slow down disease progression.
Aim and objectives To analyse the reasons for treatment discontinuation with biological drugs in patients diagnosed with rheumatoid arthritis in our hospital.
Material and methods A retrospective study was performed in which all patients diagnosed with rheumatoid arthritis treated with biological drugs at some point (between 2007 and 2016) were included. Data on biological drug dispensations, causes of treatment discontinuation, sex and age of the patients were collected. We use Excel to analyse the data.
Results 136 patients diagnosed with rheumatoid arthritis treated with a biological drug were included, with a total of 251 treatments (85 etanercept, 50 infliximab, 48 adalimumab, 23 abatacept, 11 certolizumab, 7 golimumab and 5 tocilizumab). Patients received a median of 1.8 biological drugs (range 1–6 drugs). Mean patient age was 41.12±11.33 years, and 81.9% of all patients were women. 103 patients discontinued therapy at some point in their treatment with the prescribed biological drug, corresponding to a total of 196 of 251 (78.1%). 33 patients continued with the same drug that they started treatment. 63 (74.1%) discontinuations were due to etanercept, 41 (82.0%) to infliximab, 39 (81.2%) to adalimumab, 16 to abatacept (69.6%), 20 to rituximab (90.9%), 7 to certolizumab (63.6%), 5 to golimumab (71.4%) and 5 to tocilizumab (100%). The main causes of treatment discontinuation were adverse events (29.6%), followed by secondary failure (24.5%) and primary failure (18.4%). Other reasons were patient reasons (3.6%), patient‘s illness (3.6%), remission (3.1%) and immunogenicity (1.5%). 14.8% of discontinuations were unknown. Allergic or skin reactions were the most common adverse events.
Conclusion and relevance Certolizumab was the biological drug with the lowest discontinuation rate, followed by abatacept, golimumab and etanercept. Among the different reasons for treatment discontinuation with biological drugs, adverse effects were the main cause (29.8%), with about 50% related to allergic or skin reactions.
Conflict of interest No conflict of interest
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