Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis -The ANSWER cohort study-

Ebina, Kosuke; Hashimoto, Motomu; Yamamoto, Wataru; Hirano, Toru; Hara, Ryota; Katayama, Masaki; Onishi, Akira; Nagai, Koji; Son, Yonsu; Amuro, Hideki; Yamamoto, Keiichi; Maeda, Yuichi; Murata, Koichi; Jinno, Sadao; Takeuchi, Tohru; Hirao, Makoto; Kumanogoh, Atsushi; Yoshikawa, Hideki

doi:https://doi.org/10.1371/journal.pone.0216624

Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis -The ANSWER cohort study-

Ebina, Kosuke; Hashimoto, Motomu; Yamamoto, Wataru et al.

PLoS ONE, 2019, 14(5), e0216624

アクセス数:124件（2025-04-06 21:50 集計）

固定URL: https://hdl.handle.net/11094/93209

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タイトル	Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis -The ANSWER cohort study-
著者	NRID 1000070612076 1000070612076 researchmap permalink k-ebina k-ebina Scopus Author ID 8415453300 8415453300 ORCID 0000-0002-2426-1024 0000-0002-2426-1024 著者名 Ebina, Kosuke
	NRID 1000060512845 1000060512845 著者名 Hashimoto, Motomu
	著者名 Yamamoto, Wataru
	著者名 Hirano, Toru
	NRID 1000010597107 1000010597107 著者名 Hara, Ryota
	著者名 Katayama, Masaki
	NRID 1000060634269 1000060634269 著者名 Onishi, Akira
	NRID 1000030572458 1000030572458 著者名 Nagai, Koji
	著者名 Son, Yonsu
	著者名 Amuro, Hideki
	著者名 Yamamoto, Keiichi
	NRID 1000010815658 1000010815658 Scopus Author ID 56655338200 56655338200 著者名 Maeda, Yuichi
	NRID 1000060806793 1000060806793 著者名 Murata, Koichi
	著者名 Jinno, Sadao
	NRID 1000010330078 1000010330078 著者名 Takeuchi, Tohru
	NRID 1000010527708 1000010527708 Scopus Author ID 8883255100 8883255100 著者名 Hirao, Makoto
	NRID 1000010294125 1000010294125 researchmap permalink read0051725 read0051725 Scopus Author ID 6602726311 6602726311 ORCID 0000-0003-4749-7117 0000-0003-4749-7117 著者名 Kumanogoh, Atsushi
	NRID 1000060191558 1000060191558 著者名 Yoshikawa, Hideki
内容	Ebina K., Hashimoto M., Yamamoto W., et al. (2019) Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis -The ANSWER cohort study-. PLoS ONE 14, e0216624. doi: https://doi.org/10.1371/journal.pone.0216624.
抄録	Background The aim of this study is to evaluate the retention rates and reasons for discontinuation for seven biological disease-modifying antirheumatic drugs (bDMARDs) in a real-world setting of elderly patients (65 years of age or older) with rheumatoid arthritis (RA). Methods This multi-center, retrospective study assessed 1,098 treatment courses of 661 patients with bDMARDs from 2009 to 2018 (females, 80.7%; baseline age, 71.7 years; disease duration 10.5 years; rheumatoid factor positivity 81.3%; Disease Activity Score in 28 joints using erythrocyte sedimentation rate, 4.6; concomitant prednisolone dose 2.8 mg/day (45.6%) and methotrexate dose 4.4 mg/week (56.4%); and 60.2% patients were bio-naïve). Treatment courses included abatacept (ABT; n = 272), tocilizumab (TCZ; n = 234), etanercept (ETN; n = 184), golimumab (GLM; n = 159), infliximab (IFX; n = 101), adalimumab (ADA; n = 97), and certolizumab pegol (CZP; n = 51). Drug retention rates and discontinuation reasons were estimated at 36 months using the Kaplan-Meier method and adjusted for potential clinical confounders (age, sex, disease duration, concomitant PSL and MTX, starting date and switched number of bDMARDs) by Cox proportional hazards modeling. Results A total of 51.2% of treatment courses were stopped, with 25.1% stopping due to lack of effectiveness, 11.8% due to toxic adverse events, 9.7% due to non-toxic reasons, and 4.6% due to remission. Drug retention rates for each discontinuation reason were as follows; lack of effectiveness [from 55.4% (ETN) to 81.6% (ABT); with significant differences between groups (Cox P<0.001)], toxic adverse events [from 79.3% (IFX) to 95.4% (ABT), Cox P = 0.043], and remission [from 94.2% (TCZ) to 100.0% (CZP), Cox P = 0.58]. Finally, overall retention rates excluding non-toxic reasons and remission for discontinuation ranged from 50.0% (ETN) to 78.1% (ABT) (Cox P<0.001).
出版者	Public Library of Scienceplos
収録物名	PLoS ONE
巻(号)	14(5)
ページ	e0216624
刊行年月	2019-05-08
言語	英語
ハンドルURL	https://hdl.handle.net/11094/93209
eISSN	19326203
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1371/journal.pone.0216624
アクセス権	open access
権利情報	This article is licensed under a Creative Commons Attribution 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	PLoS ONE. 2019, 14(5), p. e0216624
DC.title	Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis -The ANSWER cohort study-
DC.creator	Ebina, Kosuke
	Hashimoto, Motomu
	Yamamoto, Wataru
	Hirano, Toru
	Hara, Ryota
	Katayama, Masaki
	Onishi, Akira
	Nagai, Koji
	Son, Yonsu
	Amuro, Hideki
	Yamamoto, Keiichi
	Maeda, Yuichi
	Murata, Koichi
	Jinno, Sadao
	Takeuchi, Tohru
	Hirao, Makoto
	Kumanogoh, Atsushi
	Yoshikawa, Hideki
DC.publisher	Public Library of Scienceplos
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2019-05-08
DC.identifier	https://doi.org/10.1371/journal.pone.0216624
DC.description	Ebina K., Hashimoto M., Yamamoto W., et al. (2019) Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis -The ANSWER cohort study-. PLoS ONE 14, e0216624. doi: https://doi.org/10.1371/journal.pone.0216624.
DCTERMS.abstract	Background The aim of this study is to evaluate the retention rates and reasons for discontinuation for seven biological disease-modifying antirheumatic drugs (bDMARDs) in a real-world setting of elderly patients (65 years of age or older) with rheumatoid arthritis (RA). Methods This multi-center, retrospective study assessed 1,098 treatment courses of 661 patients with bDMARDs from 2009 to 2018 (females, 80.7%; baseline age, 71.7 years; disease duration 10.5 years; rheumatoid factor positivity 81.3%; Disease Activity Score in 28 joints using erythrocyte sedimentation rate, 4.6; concomitant prednisolone dose 2.8 mg/day (45.6%) and methotrexate dose 4.4 mg/week (56.4%); and 60.2% patients were bio-naïve). Treatment courses included abatacept (ABT; n = 272), tocilizumab (TCZ; n = 234), etanercept (ETN; n = 184), golimumab (GLM; n = 159), infliximab (IFX; n = 101), adalimumab (ADA; n = 97), and certolizumab pegol (CZP; n = 51). Drug retention rates and discontinuation reasons were estimated at 36 months using the Kaplan-Meier method and adjusted for potential clinical confounders (age, sex, disease duration, concomitant PSL and MTX, starting date and switched number of bDMARDs) by Cox proportional hazards modeling. Results A total of 51.2% of treatment courses were stopped, with 25.1% stopping due to lack of effectiveness, 11.8% due to toxic adverse events, 9.7% due to non-toxic reasons, and 4.6% due to remission. Drug retention rates for each discontinuation reason were as follows; lack of effectiveness [from 55.4% (ETN) to 81.6% (ABT); with significant differences between groups (Cox P<0.001)], toxic adverse events [from 79.3% (IFX) to 95.4% (ABT), Cox P = 0.043], and remission [from 94.2% (TCZ) to 100.0% (CZP), Cox P = 0.58]. Finally, overall retention rates excluding non-toxic reasons and remission for discontinuation ranged from 50.0% (ETN) to 78.1% (ABT) (Cox P<0.001).
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	93209
citation_title	Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis -The ANSWER cohort study-
citation_author	Ebina, Kosuke
	Hashimoto, Motomu
	Yamamoto, Wataru
	Hirano, Toru
	Hara, Ryota
	Katayama, Masaki
	Onishi, Akira
	Nagai, Koji
	Son, Yonsu
	Amuro, Hideki
	Yamamoto, Keiichi
	Maeda, Yuichi
	Murata, Koichi
	Jinno, Sadao
	Takeuchi, Tohru
	Hirao, Makoto
	Kumanogoh, Atsushi
	Yoshikawa, Hideki
citation_publisher	Public Library of Scienceplos
citation_language	英語
citation_date	2019-05-08
citation_journal_title	PLoS ONE
citation_volume	14
citation_issue	5
citation_firstpage	e0216624
citation_doi	https://doi.org/10.1371/journal.pone.0216624
citation_public_url	https://hdl.handle.net/11094/93209

Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis -The ANSWER cohort study-

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