Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study

Ebina, Kosuke; Etani, Yuki; Maeda, Yuichi; Okita, Yasutaka; Hirao, Makoto; Yamamoto, Wataru; Hashimoto, Motomu; Murata, Koichi; Hara, Ryota; Nagai, Koji; Hiramatsu, Yuri; Son, Yonsu; Amuro, Hideki; Fujii, Takayuki; Okano, Takaichi; Ueda, Yo; Katayama, Masaki; Okano, Tadashi; Tachibana, Shotaro; Hayashi, Shinya; Kumanogoh, Atsushi; Okada, Seiji; Nakata, Ken

doi:https://doi.org/10.1136/rmdopen-2023-003160

Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study

Ebina, Kosuke; Etani, Yuki; Maeda, Yuichi et al.

RMD open, 2023, 9(3)

Number of Access:2,833（2025-07-24 10:11 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/93204

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Title	Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study
Creator	NRID 1000070612076 1000070612076 researchmap permalink k-ebina k-ebina Scopus Author ID 8415453300 8415453300 ORCID 0000-0002-2426-1024 0000-0002-2426-1024 CreatorName Ebina, Kosuke
	NRID 1000060898930 1000060898930 ORCID 0000-0001-5741-5969 0000-0001-5741-5969 researchmap permalink Yetani0302 Yetani0302 CreatorName Etani, Yuki
	NRID 1000010815658 1000010815658 Scopus Author ID 56655338200 56655338200 CreatorName Maeda, Yuichi
	CreatorName Okita, Yasutaka
	NRID 1000010527708 1000010527708 Scopus Author ID 8883255100 8883255100 CreatorName Hirao, Makoto
	CreatorName Yamamoto, Wataru
	NRID 1000060512845 1000060512845 CreatorName Hashimoto, Motomu
	NRID 1000060806793 1000060806793 CreatorName Murata, Koichi
	NRID 1000010597107 1000010597107 CreatorName Hara, Ryota
	NRID 1000030572458 1000030572458 CreatorName Nagai, Koji
	NRID 1000070850072 1000070850072 CreatorName Hiramatsu, Yuri
	CreatorName Son, Yonsu
	CreatorName Amuro, Hideki
	NRID 1000030911557 1000030911557 CreatorName Fujii, Takayuki
	CreatorName Okano, Takaichi
	CreatorName Ueda, Yo
	CreatorName Katayama, Masaki
	NRID 1000050754826 1000050754826 CreatorName Okano, Tadashi
	CreatorName Tachibana, Shotaro
	NRID 1000020437487 1000020437487 CreatorName Hayashi, Shinya
	NRID 1000010294125 1000010294125 researchmap permalink read0051725 read0051725 Scopus Author ID 6602726311 6602726311 ORCID 0000-0003-4749-7117 0000-0003-4749-7117 CreatorName Kumanogoh, Atsushi
	NRID 1000030448435 1000030448435 ORCID 0000-0002-5107-8209 0000-0002-5107-8209 researchmap permalink okadaseiji okadaseiji Scopus Author ID 35079139100 35079139100 CreatorName Okada, Seiji
	NRID 1000000283747 1000000283747 researchmap permalink ken-nakata ken-nakata Scopus Author ID 7402151308 7402151308 CreatorName Nakata, Ken
Subject	antirheumatic agents
	glucocorticoids
	rheumatoid arthritis
	tumor necrosis factor inhibitors
Description	Ebina K., Etani Y., Maeda Y., et al. Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study. RMD open 9, (2023); https://doi.org/10.1136/rmdopen-2023-003160.
Abstract	OBJECTIVES: This multicentre retrospective study in Japan aimed to assess the retention of biological disease-modifying antirheumatic drugs and Janus kinase inhibitors (JAKi), and to clarify the factors affecting their retention in a real-world cohort of patients with rheumatoid arthritis. METHODS: The study included 6666 treatment courses (bDMARD-naïve or JAKi-naïve cases, 55.4%; tumour necrosis factor inhibitors (TNFi) = 3577; anti-interleukin-6 receptor antibodies (aIL-6R) = 1497; cytotoxic T lymphocyte-associated antigen-4-Ig (CTLA4-Ig) = 1139; JAKi=453 cases). The reasons for discontinuation were divided into four categories (ineffectiveness, toxic adverse events, non-toxic reasons and remission); multivariate Cox proportional hazards modelling by potential confounders was used to analyse the HRs of treatment discontinuation. RESULTS: TNFi (HR=1.93, 95% CI: 1.69 to 2.19), CTLA4-Ig (HR=1.42, 95% CI: 1.20 to 1.67) and JAKi (HR=1.29, 95% CI: 1.03 to 1.63) showed a higher discontinuation rate due to ineffectiveness than aIL-6R. TNFi (HR=1.28, 95% CI: 1.05 to 1.56) and aIL-6R (HR=1.27, 95% CI: 1.03 to 1.57) showed a higher discontinuation rate due to toxic adverse events than CTLA4-Ig. Concomitant use of oral glucocorticoids (GCs) at baseline was associated with higher discontinuation rate due to ineffectiveness in TNFi (HR=1.24, 95% CI: 1.09 to 1.41), as well as toxic adverse events in JAKi (HR=2.30, 95% CI: 1.23 to 4.28) and TNFi (HR=1.29, 95%CI: 1.07 to 1.55). CONCLUSIONS: TNFi (HR=1.52, 95% CI: 1.37 to 1.68) and CTLA4-Ig (HR=1.14, 95% CI: 1.00 to 1.30) showed a higher overall drug discontinuation rate, excluding non-toxicity and remission, than aIL-6R.
Publisher	NLM (Medline)
Source Title	RMD open
Volume (Issue)	9(3)
Date of Issued	2023-08-18
Language	English
Handle URL	https://hdl.handle.net/11094/93204
eISSN	20565933
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1136/rmdopen-2023-003160
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	RMD open. 2023, 9(3)
DC.title	Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study
DC.creator	Ebina, Kosuke
	Etani, Yuki
	Maeda, Yuichi
	Okita, Yasutaka
	Hirao, Makoto
	Yamamoto, Wataru
	Hashimoto, Motomu
	Murata, Koichi
	Hara, Ryota
	Nagai, Koji
	Hiramatsu, Yuri
	Son, Yonsu
	Amuro, Hideki
	Fujii, Takayuki
	Okano, Takaichi
	Ueda, Yo
	Katayama, Masaki
	Okano, Tadashi
	Tachibana, Shotaro
	Hayashi, Shinya
	Kumanogoh, Atsushi
	Okada, Seiji
	Nakata, Ken
DC.publisher	NLM (Medline)
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2023-08-18
DC.identifier	https://doi.org/10.1136/rmdopen-2023-003160
DC.subject	antirheumatic agents
	glucocorticoids
	rheumatoid arthritis
	tumor necrosis factor inhibitors
DC.description	Ebina K., Etani Y., Maeda Y., et al. Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study. RMD open 9, (2023); https://doi.org/10.1136/rmdopen-2023-003160.
DCTERMS.abstract	OBJECTIVES: This multicentre retrospective study in Japan aimed to assess the retention of biological disease-modifying antirheumatic drugs and Janus kinase inhibitors (JAKi), and to clarify the factors affecting their retention in a real-world cohort of patients with rheumatoid arthritis. METHODS: The study included 6666 treatment courses (bDMARD-naïve or JAKi-naïve cases, 55.4%; tumour necrosis factor inhibitors (TNFi) = 3577; anti-interleukin-6 receptor antibodies (aIL-6R) = 1497; cytotoxic T lymphocyte-associated antigen-4-Ig (CTLA4-Ig) = 1139; JAKi=453 cases). The reasons for discontinuation were divided into four categories (ineffectiveness, toxic adverse events, non-toxic reasons and remission); multivariate Cox proportional hazards modelling by potential confounders was used to analyse the HRs of treatment discontinuation. RESULTS: TNFi (HR=1.93, 95% CI: 1.69 to 2.19), CTLA4-Ig (HR=1.42, 95% CI: 1.20 to 1.67) and JAKi (HR=1.29, 95% CI: 1.03 to 1.63) showed a higher discontinuation rate due to ineffectiveness than aIL-6R. TNFi (HR=1.28, 95% CI: 1.05 to 1.56) and aIL-6R (HR=1.27, 95% CI: 1.03 to 1.57) showed a higher discontinuation rate due to toxic adverse events than CTLA4-Ig. Concomitant use of oral glucocorticoids (GCs) at baseline was associated with higher discontinuation rate due to ineffectiveness in TNFi (HR=1.24, 95% CI: 1.09 to 1.41), as well as toxic adverse events in JAKi (HR=2.30, 95% CI: 1.23 to 4.28) and TNFi (HR=1.29, 95%CI: 1.07 to 1.55). CONCLUSIONS: TNFi (HR=1.52, 95% CI: 1.37 to 1.68) and CTLA4-Ig (HR=1.14, 95% CI: 1.00 to 1.30) showed a higher overall drug discontinuation rate, excluding non-toxicity and remission, than aIL-6R.
DC.rights	This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
DC.format	93204
citation_title	Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study
citation_author	Ebina, Kosuke
	Etani, Yuki
	Maeda, Yuichi
	Okita, Yasutaka
	Hirao, Makoto
	Yamamoto, Wataru
	Hashimoto, Motomu
	Murata, Koichi
	Hara, Ryota
	Nagai, Koji
	Hiramatsu, Yuri
	Son, Yonsu
	Amuro, Hideki
	Fujii, Takayuki
	Okano, Takaichi
	Ueda, Yo
	Katayama, Masaki
	Okano, Tadashi
	Tachibana, Shotaro
	Hayashi, Shinya
	Kumanogoh, Atsushi
	Okada, Seiji
	Nakata, Ken
citation_publisher	NLM (Medline)
citation_language	English
citation_date	2023-08-18
citation_journal_title	RMD open
citation_volume	9
citation_issue	3
citation_doi	https://doi.org/10.1136/rmdopen-2023-003160
citation_public_url	https://hdl.handle.net/11094/93204

Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study

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