Online citations, reference lists, and bibliographies.
Please confirm you are human
(Sign Up for free to never see this)
← Back to Search

Discontinuation Of Anti-TNF-α Therapy In A Chinese Cohort Of Patients With Rheumatoid Arthritis

Cheng-Tao Yang, C. Kuo, S. Luo, K. Yu
Published 2012 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy
Share
The aim of this retrospective study was to examine the predictors of discontinuation of anti-tumor necrosis factor (TNF) therapy due to adverse events in Chinese patients with rheumatoid arthritis (RA). Anti-TNF-related adverse events were recorded and analyzed in 217 consecutive patients with RA followed in our institution from 2003 to 2010. Time to discontinuation of anti-TNF-α therapy was estimated using survival analysis techniques. The anti-TNF agents administered were etanercept in 181 patients and adalimumab in 36 patients. The mean age at diagnosis was 45.2 ± 13.5 years, and mean age at initiation of anti-TNF therapy was 51.8 ± 13.0 years. The mean duration of anti-TNF agent use was 36.0 ± 26.5 months (range, 1.4–87.0; median, 26.4 months). Of the 217 patients, 39 (18.0 %) developed adverse events [etanercept in 34 (18.8 %] and adalimumab in 5 (13.9 %)] during the treatment period (tuberculosis in 5, bacterial infections in 19, virus infection in 7, neuropathy in 3, malignancy in 3, other drug-related events in 1, and appendicitis in 1). In patients with RA, older age (≥55 years) at initiation of anti-TNF therapy [odds ratio (OR), 3.20; 95 % confidence interval (CI), 1.67–6.20; p < 0.001], Cr ≥1.5 mg/dL (OR, 5.72; 95 % CI, 1.17–27.90; p = 0.031), and occurrence of adverse events (OR, 3.82; 95 % CI, 1.75–8.35; p = 0.001) were associated with increased likelihood of discontinuation of anti-TNF treatment. In the present study, a significant proportion (7.8 %, 17/217) of patients with RA discontinued anti-TNF treatment because of adverse events. In the elderly and in patients with renal insufficiency, caution is needed when starting anti-TNF treatment.
This paper references
Risk of tuberculosis in patients with rheumatoid arthritis in Hong Kong--the role of TNF blockers in an area of high tuberculosis burden.
L. Tam (2010)
10.1136/ard.2009.121491
Discontinuation of infliximab after attaining low disease activity in patients with rheumatoid arthritis: RRR (remission induction by Remicade in RA) study
Y. Tanaka (2010)
10.1002/art.24632
Risk of tuberculosis is higher with anti-tumor necrosis factor monoclonal antibody therapy than with soluble tumor necrosis factor receptor therapy: The three-year prospective French Research Axed on Tolerance of Biotherapies registry.
F. Tubach (2009)
10.1002/ART.1780310302
The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.
F. Arnett (1988)
10.1016/J.JINF.2005.08.008
Mycobacterium tuberculosis in Taiwan.
P. Hsueh (2006)
10.1016/S0140-6736(99)05246-0
Infliximab (chimeric anti-tumour necrosis factor α monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial
R. Maini (1999)
10.3899/jrheum.101142
Persistence with Anti-Tumor Necrosis Factor Therapies in Patients with Rheumatoid Arthritis: Observations from the RADIUS Registry
J. Markenson (2011)
10.1002/art.22808
Serious Infection Following Anti–Tumor Necrosis Factor α Therapy in Patients With Rheumatoid Arthritis: Lessons From Interpreting Data From Observational Studies
W. Dixon (2007)
10.1136/ard.2008.094730
Influence of age on the outcome of antitumour necrosis factor alpha therapy in rheumatoid arthritis
B. J. Radovits (2009)
10.1007/s00296-005-0097-9
Biological treatment in rheumatic diseases: results from a longitudinal surveillance: adverse events
L. Konttinen (2005)
10.1097/BOR.0b013e3282fa74f7
Association of infections and tuberculosis with antitumor necrosis factor alpha therapy
N. Patkar (2008)
[Rheumatoid arthritis].
C. Werning (1983)
10.1080/03009740701633337
Infliximab treatment in patients with rheumatoid arthritis and spondyloarthropathies in clinical practice: adverse events and other reasons for discontinuation of treatment
T. Levälampi (2008)
10.1002/ART.10697
Adalimumab, a fully human anti-tumor necrosis factor alpha monoclonal antibody, for the treatment of rheumatoid arthritis in patients taking concomitant methotrexate: the ARMADA trial.
M. Weinblatt (2003)
10.1056/NEJM199901283400401
A trial of etanercept, a recombinant tumor necrosis factor receptor:Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate.
M. Weinblatt (1999)
10.1016/0049-0172(94)90087-6
Elderly-onset rheumatoid arthritis.
D. van Schaardenburg (1994)
10.1111/j.1749-6632.2009.04621.x
TNF‐α Antagonist Survival Rate in a Cohort of Rheumatoid Arthritis Patients Observed under Conditions of Standard Clinical Practice
A. Marchesoni (2009)
10.1002/ART.21978
Rates of serious infection, including site-specific and bacterial intracellular infection, in rheumatoid arthritis patients receiving anti-tumor necrosis factor therapy: results from the British Society for Rheumatology Biologics Register.
W. Dixon (2006)
10.1002/ART.1780390122
The antiinflammatory and antiviral effects of hydroxychloroquine in two patients with acquired immunodeficiency syndrome and active inflammatory arthritis.
M. Ornstein (1996)
10.1001/jama.2009.146
Risk of herpes zoster in patients with rheumatoid arthritis treated with anti-TNF-alpha agents.
A. Strangfeld (2009)
10.3899/jrheum.090054
The Reason for Discontinuation of the First Tumor Necrosis Factor (TNF) Blocking Agent Does Not Influence the Effect of a Second TNF Blocking Agent in Patients with Rheumatoid Arthritis
M. Blom (2009)
10.1007/S10165-006-0486-2
The clinical application of etanercept in Chinese patients with rheumatic diseases
Chung-Tei Chou (2006)
10.1016/j.berh.2008.09.008
Autoimmune diseases induced by TNF-targeted therapies.
M. Ramos-Casals (2008)
10.1007/s00296-007-0436-0
Etanercept and adalimumab treatment in patients with rheumatoid arthritis and spondyloarthropathies in clinical practice: adverse events and other reasons leading to discontinuation of the treatment
T. Levälampi (2007)
10.1002/j.1875-9114.1990.tb02553.x
Second‐Line Antirheumatic Drugs in the Elderly with Rheumatoid Arthritis: A Post Hoc Analysis of Three Controlled Trials
S. Dahl (1990)
10.1002/art.24463
Comparison of drug retention rates and causes of drug discontinuation between anti-tumor necrosis factor agents in rheumatoid arthritis.
Sophie Martin Du Pan (2009)
10.1016/S0065-2776(02)80017-7
The aging of the immune system.
B. Grubeck‐Loebenstein (2002)
10.1016/S0929-6646(09)60071-1
Randomized, double-blind, placebo-controlled, comparative study of human anti-TNF antibody adalimumab in combination with methotrexate and methotrexate alone in Taiwanese patients with active rheumatoid arthritis.
D. Chen (2009)
10.1186/1471-2474-9-52
Tumor necrosis factor alpha drugs in rheumatoid arthritis: systematic review and metaanalysis of efficacy and safety
A. Alonso-Ruiz (2008)
10.1097/00006416-199003000-00011
Revised criteria for the classification of rheumatoid arthritis.
F. Arnett (1990)
10.1016/S0889-857X(05)70151-4
Changes in immune function with age.
R. Yung (2000)
The pathogenesis of rheumatoid arthritis.
A. Koch (2007)
10.1097/00019048-200112000-00012
Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent.
J. Keane (2001)
10.1002/art.23705
Effectiveness of the combination of a whole-blood interferon-gamma assay and the tuberculin skin test in detecting latent tuberculosis infection in rheumatoid arthritis patients receiving adalimumab therapy.
D. Chen (2008)
10.1016/S1473-3099(03)00545-0
Anti-tumour necrosis factor agents and tuberculosis risk: mechanisms of action and clinical management.
M. Gardam (2003)



This paper is referenced by
Semantic Scholar Logo Some data provided by SemanticScholar