Analysis of Switching Biological Agents in Treatment of Rheumatoid Arthritis and Ankylosing Spondylitis

INTRODUCTION: Biological disease-modifying anti rheumatic drugs (bDMARDs) have been used in the treatment of rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The aim of the study was to investigate the switching patterns of bDMARDs, the drug survival rates and the reasons for switching in patients with RA and AS by means of Real-World data. METHODS: The study was designed as retrospective, single center, and observational. One hundred and two patients (55 RA, 47 AS) who switched at least one biologic agent were included in the study. The drug survival time and causes of switching bDMARDs were recorded. The Kaplan-Meier analysis and Log-Rank tests were performed to analyze the survival curves of each biological agent and compare the results between groups. RESULTS: Of 102, 55 patients (53.9%) were RA, 47 patients (46.1%) were AS. First switching ratio of RA was 23.7% whilst it was 21.5% in AS. Second switching rates were 5.5% and 4.3% in RA and AS patients, respectively. The most three causes of switching were loss of efficacy, the occurrence of new clinical conditions, and adverse events. In the Kaplan Meier analysis, the higher continuance of using the first bDMARD was observed in AS than in RA (p=0.039, Log-Rank test). Among the first bDMARDs, the drug survival rate of Etanercept was higher in AS patients than in RA. (p=0.036, Log-Rank test). DISCUSSION AND CONCLUSION: The first and second switching ratios of bDMARDs, and switching causes were similar between groups. The drug survival rate was longer in AS than in RA.

Romatoid artrit ve Ankilozan Spondilit Tedavisinde Biyolojik Ajanların Değişimlerinin Analizi

GİRİŞ ve AMAÇ: Hastalığı modifiye edici biyolojik antiromatizmal ilaçlar (bDMARDs), romatoid artrit (RA) ve ankilozan spondilit (AS) tedavisinde kullanılmaktadırlar. Bu çalışmada, bDMARDs değişim paternlerinin, ilaç tedavisinde kalım sürelerinin ve RA ile AS hastalarında ilaç değişim nedenlerinin gerçek dünya verileri ışığında araştırılması amaçlandı. YÖNTEM ve GEREÇLER: Çalışma, retrospektif, tek merkezli, gözlemsel bir çalışma olarak dizayn edildi. Çalışmaya, en az 1 kez bDMARDs değişimi yapmış 102 hasta (55 RA ve 47 AS) dahil edildi. İlaç tedavisinde kalım süreleri ve bDMARDs değişim nedenleri kaydedildi. Her biyolojik ajan için ilaç devamlılık sürelerini analiz etmek ve gruplar arası karşılaştırma yapmak için Kaplan-Meier analizi ve Log-Rank testi kullanıldı. BULGULAR: Ellibeş (%53.9) hasta RA iken, 47 (%46.1) hasta AS idi. İlk değişim oranı RA hastalarında %23.7 iken, bu oran AS hastalarında %21.5 idi. İkinci ilaç değişim oranları RA hastalarında %5.5 ve AS hastalarında %4.3 bulundu. En sık görülen üç ilaç değişim nedeni sırası ile; ilaç etkinliğinin kaybı, yeni gelişen klinik durumlar ve yan etkilerdi. Kaplan Meier analizie göre, ilk biyolojik ilaç tedavisinde kalım süresi, AS’de RA’ya göre daha yüksekti (p=0.039, Log-Rank test). İlk seçilen bDMARD’lar arasında, Etanercept ile ilaç tedavisinde kalım süresi AS’de RA hastalarından daha uzundu (p=0.036, Log-Rank test). TARTIŞMA ve SONUÇ: bDMARDs’ların ilk ve ikinci ilaç değişim oranları ve değişim nedenleri gruplar arasında benzerdi. İlk bDMARD tedavisinde kalım süresi, AS hastalarında RA hastalarından daha uzundu.

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  • ISSN: 2147-0758
  • Başlangıç: 2012
  • Yayıncı: -
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