Five-year survival on infliximab in rheumatoid arthritis patients: Analysis from an Italian registry (GISEA) by different calendar years

Florenzo Iannone, Fausto Salaffi, Antonio Marchesoni, Roberto Gorla, Fabiola Atzeni, Marcello Govoni, Elisa Gremese, Giovanni Lapadula, E. G. Favalli, C. Bazzani, P. Sarzi-Puttini, S. Lopriore, D. Simone, C. Caimmi

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Abstract

Objective To assess long-term drug survival and effectiveness in biological drug-naïve patients with rheumatoid arthritis (RA), starting infliximab as first treatment, in the period 2000-2009, comparing different calendar years. Methods Patients with RA recorded in the GISEA registry beginning infliximab as first ever biological drug were enrolled, subdivided into periods 2000-2002, 2003-2005, and 2006-2009. We evaluated 5-year drug survival by Kaplan-Meier life analysis and 1-year EULAR responses based on the 28 joint count Disease Activity Score (DAS28), and baseline predictors, by multiple logistic regression analysis. Results Of 565 RA patients included in the analysis, 290 (51.3%) began infliximab in years 2000-2002, 167 (29.5%) in 2003-2005, and 108 (19.1%) in 2006-2009. At entry, DAS28-ESR was significantly lower in 2006-2009 (5.1±1.3) than in 2000-2002 (6.0±1.2) or 2003-2006 (6.0±1.0) (p=0.001). Significantly more RA patients attained a EULAR "good" response at 1 year in 2006-2009 (39.8%) than in 2000-2002 (23.1%, p=0.001). Nevertheless, the rate of drug survival at 5 years, roughly 40%, was not significantly different over the calendar periods. Co-administration of DMARDs was significantly correlated with drug survival (Odds Ratio (OR) 1.42, 95% Confidence Intervals (CI) 1.005-2.09, p=0.04), but not the period when starting treatment. Instead, a EULAR "good" response was significantly correlated with the period 2006-2009 (OR 2.24, 95% CI 1.37-3.65, p=0.02). Conclusion Our study shows that RA patients have similar drug survival on infliximab regardless of the period when they started. However, patients treated in more recent years tend to have less active RA and to more readily attain favourable clinical outcomes.

Original languageEnglish
Pages (from-to)524-530
Number of pages7
JournalClinical and Experimental Rheumatology
Volume33
Issue number4
Publication statusPublished - 2015

Fingerprint

Registries
Rheumatoid Arthritis
Survival
Pharmaceutical Preparations
Odds Ratio
Confidence Intervals
Antirheumatic Agents
Joint Diseases
Kaplan-Meier Estimate
Infliximab
Survival Rate
Logistic Models
Regression Analysis
Therapeutics

Keywords

  • Anti-TNF
  • GISEA
  • Infliximab

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy
  • Medicine(all)

Cite this

Iannone, F., Salaffi, F., Marchesoni, A., Gorla, R., Atzeni, F., Govoni, M., ... Caimmi, C. (2015). Five-year survival on infliximab in rheumatoid arthritis patients: Analysis from an Italian registry (GISEA) by different calendar years. Clinical and Experimental Rheumatology, 33(4), 524-530.

Five-year survival on infliximab in rheumatoid arthritis patients : Analysis from an Italian registry (GISEA) by different calendar years. / Iannone, Florenzo; Salaffi, Fausto; Marchesoni, Antonio; Gorla, Roberto; Atzeni, Fabiola; Govoni, Marcello; Gremese, Elisa; Lapadula, Giovanni; Favalli, E. G.; Bazzani, C.; Sarzi-Puttini, P.; Lopriore, S.; Simone, D.; Caimmi, C.

In: Clinical and Experimental Rheumatology, Vol. 33, No. 4, 2015, p. 524-530.

Research output: Contribution to journalArticle

Iannone, F, Salaffi, F, Marchesoni, A, Gorla, R, Atzeni, F, Govoni, M, Gremese, E, Lapadula, G, Favalli, EG, Bazzani, C, Sarzi-Puttini, P, Lopriore, S, Simone, D & Caimmi, C 2015, 'Five-year survival on infliximab in rheumatoid arthritis patients: Analysis from an Italian registry (GISEA) by different calendar years', Clinical and Experimental Rheumatology, vol. 33, no. 4, pp. 524-530.
Iannone, Florenzo ; Salaffi, Fausto ; Marchesoni, Antonio ; Gorla, Roberto ; Atzeni, Fabiola ; Govoni, Marcello ; Gremese, Elisa ; Lapadula, Giovanni ; Favalli, E. G. ; Bazzani, C. ; Sarzi-Puttini, P. ; Lopriore, S. ; Simone, D. ; Caimmi, C. / Five-year survival on infliximab in rheumatoid arthritis patients : Analysis from an Italian registry (GISEA) by different calendar years. In: Clinical and Experimental Rheumatology. 2015 ; Vol. 33, No. 4. pp. 524-530.
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abstract = "Objective To assess long-term drug survival and effectiveness in biological drug-na{\"i}ve patients with rheumatoid arthritis (RA), starting infliximab as first treatment, in the period 2000-2009, comparing different calendar years. Methods Patients with RA recorded in the GISEA registry beginning infliximab as first ever biological drug were enrolled, subdivided into periods 2000-2002, 2003-2005, and 2006-2009. We evaluated 5-year drug survival by Kaplan-Meier life analysis and 1-year EULAR responses based on the 28 joint count Disease Activity Score (DAS28), and baseline predictors, by multiple logistic regression analysis. Results Of 565 RA patients included in the analysis, 290 (51.3{\%}) began infliximab in years 2000-2002, 167 (29.5{\%}) in 2003-2005, and 108 (19.1{\%}) in 2006-2009. At entry, DAS28-ESR was significantly lower in 2006-2009 (5.1±1.3) than in 2000-2002 (6.0±1.2) or 2003-2006 (6.0±1.0) (p=0.001). Significantly more RA patients attained a EULAR {"}good{"} response at 1 year in 2006-2009 (39.8{\%}) than in 2000-2002 (23.1{\%}, p=0.001). Nevertheless, the rate of drug survival at 5 years, roughly 40{\%}, was not significantly different over the calendar periods. Co-administration of DMARDs was significantly correlated with drug survival (Odds Ratio (OR) 1.42, 95{\%} Confidence Intervals (CI) 1.005-2.09, p=0.04), but not the period when starting treatment. Instead, a EULAR {"}good{"} response was significantly correlated with the period 2006-2009 (OR 2.24, 95{\%} CI 1.37-3.65, p=0.02). Conclusion Our study shows that RA patients have similar drug survival on infliximab regardless of the period when they started. However, patients treated in more recent years tend to have less active RA and to more readily attain favourable clinical outcomes.",
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AU - Salaffi, Fausto

AU - Marchesoni, Antonio

AU - Gorla, Roberto

AU - Atzeni, Fabiola

AU - Govoni, Marcello

AU - Gremese, Elisa

AU - Lapadula, Giovanni

AU - Favalli, E. G.

AU - Bazzani, C.

AU - Sarzi-Puttini, P.

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N2 - Objective To assess long-term drug survival and effectiveness in biological drug-naïve patients with rheumatoid arthritis (RA), starting infliximab as first treatment, in the period 2000-2009, comparing different calendar years. Methods Patients with RA recorded in the GISEA registry beginning infliximab as first ever biological drug were enrolled, subdivided into periods 2000-2002, 2003-2005, and 2006-2009. We evaluated 5-year drug survival by Kaplan-Meier life analysis and 1-year EULAR responses based on the 28 joint count Disease Activity Score (DAS28), and baseline predictors, by multiple logistic regression analysis. Results Of 565 RA patients included in the analysis, 290 (51.3%) began infliximab in years 2000-2002, 167 (29.5%) in 2003-2005, and 108 (19.1%) in 2006-2009. At entry, DAS28-ESR was significantly lower in 2006-2009 (5.1±1.3) than in 2000-2002 (6.0±1.2) or 2003-2006 (6.0±1.0) (p=0.001). Significantly more RA patients attained a EULAR "good" response at 1 year in 2006-2009 (39.8%) than in 2000-2002 (23.1%, p=0.001). Nevertheless, the rate of drug survival at 5 years, roughly 40%, was not significantly different over the calendar periods. Co-administration of DMARDs was significantly correlated with drug survival (Odds Ratio (OR) 1.42, 95% Confidence Intervals (CI) 1.005-2.09, p=0.04), but not the period when starting treatment. Instead, a EULAR "good" response was significantly correlated with the period 2006-2009 (OR 2.24, 95% CI 1.37-3.65, p=0.02). Conclusion Our study shows that RA patients have similar drug survival on infliximab regardless of the period when they started. However, patients treated in more recent years tend to have less active RA and to more readily attain favourable clinical outcomes.

AB - Objective To assess long-term drug survival and effectiveness in biological drug-naïve patients with rheumatoid arthritis (RA), starting infliximab as first treatment, in the period 2000-2009, comparing different calendar years. Methods Patients with RA recorded in the GISEA registry beginning infliximab as first ever biological drug were enrolled, subdivided into periods 2000-2002, 2003-2005, and 2006-2009. We evaluated 5-year drug survival by Kaplan-Meier life analysis and 1-year EULAR responses based on the 28 joint count Disease Activity Score (DAS28), and baseline predictors, by multiple logistic regression analysis. Results Of 565 RA patients included in the analysis, 290 (51.3%) began infliximab in years 2000-2002, 167 (29.5%) in 2003-2005, and 108 (19.1%) in 2006-2009. At entry, DAS28-ESR was significantly lower in 2006-2009 (5.1±1.3) than in 2000-2002 (6.0±1.2) or 2003-2006 (6.0±1.0) (p=0.001). Significantly more RA patients attained a EULAR "good" response at 1 year in 2006-2009 (39.8%) than in 2000-2002 (23.1%, p=0.001). Nevertheless, the rate of drug survival at 5 years, roughly 40%, was not significantly different over the calendar periods. Co-administration of DMARDs was significantly correlated with drug survival (Odds Ratio (OR) 1.42, 95% Confidence Intervals (CI) 1.005-2.09, p=0.04), but not the period when starting treatment. Instead, a EULAR "good" response was significantly correlated with the period 2006-2009 (OR 2.24, 95% CI 1.37-3.65, p=0.02). Conclusion Our study shows that RA patients have similar drug survival on infliximab regardless of the period when they started. However, patients treated in more recent years tend to have less active RA and to more readily attain favourable clinical outcomes.

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