Drug survival longer with etanercept vs other TNFi for rheumatoid arthritis

There are more rheumatoid arthritis (RA) patients receiving etanercept (ETN) who remain on treatment compared with those taking other tumour necrosis factor inhibitors (TNFi) after >12 months of follow-up, reports a study.

The investigators conducted a systematic literature review and estimated drug survival (proportion of patients still receiving treatment) at 12 and 12–24 months of follow-up by summing proportions of patients continuing treatment and dividing by number of studies. Metaprop was used to estimate drug survival at ≥36 months of follow-up.

In total, 170 publications were included. In the first-line setting, drug survival with ETN, infliximab (IFX) or adalimumab (ADA) at 12 months was 71 percent, 69 percent and 70 percent, respectively, while the corresponding rates at 12–24 months were 63 percent, 57 percent and 59 percent.

In the second-line setting, drug survival at 12 months was 61 percent with ETN, 69 percent with IFX and 55 percent with ADA, while the corresponding rates at 12–24 months were 53 percent, 39 percent and 43 percent.

At ≥36 months, drug survival in the first-line setting was 59 percent (95 percent confidence interval [CI], 46–72) with ETN, 49 percent (95 percent CI, 43–54) with IFX and 51 percent (95 percent CI, 41–60) with ADA, while the corresponding rates in the second-line setting were 56 percent (95 percent CI, 52–61), 48 percent (95 percent CI, 40–50) and 41 percent (95 percent CI, 36–47).

Discontinuation at 36 months of follow-up was 38–48 percent with ETN, 42–62 percent with IFX and 38–59 percent with ADA. On the other hand, data were scarce for certolizumab pegol and golimumab.