Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry

Merete Lund Hetland; Ib Jarle Christensen; Ulrik Tarp; Lene Dreyer; Annette Hansen; Ib Tønder Hansen; Gina Kollerup; Louise Linde; Hanne M Lindegaard; Uta Engling Poulsen; Annette Schlemmer; Dorte Vendelbo Jensen; Signe Jensen; Gisela Hostenkamp; Mikkel Østergaard; All Departments; Merete Lund Hetland; Ib Jarle Christensen; Ulrik Tarp; Lene Dreyer; Annette Hansen; Ib Tønder Hansen; Gina Birgitte Kollerup; Louise Linde; Hanne Merete Lindegaard; Uta Engling Poulsen; Annette Schlemmer; Dorte Vendelbo Jensen; Signe Jensen; Gisela Hostenkamp; Mikkel Østergaard; All Departments of Rheumatology in Denmark

doi:10.1002/art.27227

Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry

Merete Lund Hetland, Ib Jarle Christensen, Ulrik Tarp, Lene Dreyer, Annette Hansen, Ib Tønder Hansen, Gina Kollerup, Louise Linde, Hanne M Lindegaard, Uta Engling Poulsen, Annette Schlemmer, Dorte Vendelbo Jensen, Signe Jensen, Gisela Hostenkamp, Mikkel Østergaard, All Departments, Merete Lund Hetland, Ib Jarle Christensen, Ulrik Tarp, Lene DreyerAnnette Hansen, Ib Tønder Hansen, Gina Birgitte Kollerup, Louise Linde, Hanne Merete Lindegaard, Uta Engling Poulsen, Annette Schlemmer, Dorte Vendelbo Jensen, Signe Jensen, Gisela Hostenkamp, Mikkel Østergaard, All Departments of Rheumatology in Denmark

415 Citations (Scopus)

Abstract

Objective. To compare tumor necrosis factor α inhibitors directly regarding the rates of treatment response, remission, and the drug survival rate in patients with rheumatoid arthritis (RA), and to identify clinical prognostic factors for response. Methods. The nationwide DANBIO registry collects data on rheumatology patients receiving routine care. For the present study, we included patients from DANBIO who had RA (n = 2,326) in whom the first biologic treatment was initiated (29% received adalimumab, 22% received etanercept, and 49% received infliximab). Baseline predictors of treatment response were identified. The odds ratios (ORs) for clinical responses and remission and hazard ratios (HRs) for drug withdrawal were calculated, corrected for age, disease duration, the Disease Activity Score in 28 joints (DAS28), seropositivity, concomitant methotrexate and prednisolone, number of previous disease-modifying drugs, center, and functional status (Health Assessment Questionnaire score). Results. Seventy percent improvement according to the American College of Rheumatology criteria (an ACR70 response) was achieved in 19% of patients after 6 months. Older age, concomitant prednisolone treatment, and low functional status at baseline were negative predictors. The ORs (95% confidence intervals [95% CIs]) for an ACR70 response were 2.05 (95% CI 1.52-2.76) for adalimumab versus infliximab, 1.78 (95% CI 1.28-2.50) for etanercept versus infliximab, and 1.15 (95% CI 0.82-1.60) for adalimumab versus etanercept. Similar predictors and ORs were observed for a good response according to the European League Against Rheumatism criteria, DAS28 remission, and Clinical Disease Activity Index remission. At 48 months, the HRs for drug withdrawal were 1.98 for infliximab versus etanercept (95% 1.63-2.40), 1.35 for infliximab versus adalimumab (95% CI 1.15-1.58), and 1.47 for adalimumab versus etanercept (95% CI 1.20-1.80). Conclusion. Older age, low functional status, and concomitant prednisolone treatment were negative predictors of a clinical response and remission. Infliximab had the lowest rates of treatment response, disease remission, and drug adherence, adalimumab had the highest rates of treatment response and disease remission, and etanercept had the longest drug survival rates. These findings were consistent after correction for confounders and sensitivity analyses and across outcome measures and followup times.

Original language	English
Journal	Arthritis & Rheumatism
Volume	62
Issue number	1
Pages (from-to)	22-32
Number of pages	11
ISSN	0004-3591
DOIs	https://doi.org/10.1002/art.27227
Publication status	Published - 1 Jan 2010

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Hetland, M. L., Christensen, I. J., Tarp, U., Dreyer, L., Hansen, A., Hansen, I. T., Kollerup, G., Linde, L., Lindegaard, H. M., Poulsen, U. E., Schlemmer, A., Jensen, D. V., Jensen, S., Hostenkamp, G., Østergaard, M., Departments, A., Hetland, M. L., Christensen, I. J., Tarp, U., ... All Departments of Rheumatology in Denmark (2010). Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry. Arthritis & Rheumatism, 62(1), 22-32. https://doi.org/10.1002/art.27227

Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry. / Hetland, Merete Lund; Christensen, Ib Jarle; Tarp, Ulrik et al.

In: Arthritis & Rheumatism, Vol. 62, No. 1, 01.01.2010, p. 22-32.

Research output: Contribution to journal › Journal article › Research › peer-review

Hetland, ML, Christensen, IJ, Tarp, U, Dreyer, L, Hansen, A, Hansen, IT, Kollerup, G, Linde, L, Lindegaard, HM, Poulsen, UE, Schlemmer, A, Jensen, DV, Jensen, S, Hostenkamp, G, Østergaard, M, Departments, A, Hetland, ML, Christensen, IJ, Tarp, U, Dreyer, L, Hansen, A, Hansen, IT, Kollerup, GB, Linde, L, Lindegaard, HM, Poulsen, UE, Schlemmer, A, Jensen, DV, Jensen, S, Hostenkamp, G, Østergaard, M & All Departments of Rheumatology in Denmark 2010, 'Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry', Arthritis & Rheumatism, vol. 62, no. 1, pp. 22-32. https://doi.org/10.1002/art.27227

Hetland ML, Christensen IJ, Tarp U, Dreyer L, Hansen A, Hansen IT et al. Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry. Arthritis & Rheumatism. 2010 Jan 1;62(1):22-32. doi: 10.1002/art.27227

Hetland, Merete Lund ; Christensen, Ib Jarle ; Tarp, Ulrik et al. / Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry. In: Arthritis & Rheumatism. 2010 ; Vol. 62, No. 1. pp. 22-32.

@article{26b456f06a3811df928f000ea68e967b,

title = "Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry",

abstract = "Objective. To compare tumor necrosis factor α inhibitors directly regarding the rates of treatment response, remission, and the drug survival rate in patients with rheumatoid arthritis (RA), and to identify clinical prognostic factors for response. Methods. The nationwide DANBIO registry collects data on rheumatology patients receiving routine care. For the present study, we included patients from DANBIO who had RA (n = 2,326) in whom the first biologic treatment was initiated (29% received adalimumab, 22% received etanercept, and 49% received infliximab). Baseline predictors of treatment response were identified. The odds ratios (ORs) for clinical responses and remission and hazard ratios (HRs) for drug withdrawal were calculated, corrected for age, disease duration, the Disease Activity Score in 28 joints (DAS28), seropositivity, concomitant methotrexate and prednisolone, number of previous disease-modifying drugs, center, and functional status (Health Assessment Questionnaire score). Results. Seventy percent improvement according to the American College of Rheumatology criteria (an ACR70 response) was achieved in 19% of patients after 6 months. Older age, concomitant prednisolone treatment, and low functional status at baseline were negative predictors. The ORs (95% confidence intervals [95% CIs]) for an ACR70 response were 2.05 (95% CI 1.52-2.76) for adalimumab versus infliximab, 1.78 (95% CI 1.28-2.50) for etanercept versus infliximab, and 1.15 (95% CI 0.82-1.60) for adalimumab versus etanercept. Similar predictors and ORs were observed for a good response according to the European League Against Rheumatism criteria, DAS28 remission, and Clinical Disease Activity Index remission. At 48 months, the HRs for drug withdrawal were 1.98 for infliximab versus etanercept (95% 1.63-2.40), 1.35 for infliximab versus adalimumab (95% CI 1.15-1.58), and 1.47 for adalimumab versus etanercept (95% CI 1.20-1.80). Conclusion. Older age, low functional status, and concomitant prednisolone treatment were negative predictors of a clinical response and remission. Infliximab had the lowest rates of treatment response, disease remission, and drug adherence, adalimumab had the highest rates of treatment response and disease remission, and etanercept had the longest drug survival rates. These findings were consistent after correction for confounders and sensitivity analyses and across outcome measures and followup times.",

author = "Hetland, {Merete Lund} and Christensen, {Ib Jarle} and Ulrik Tarp and Lene Dreyer and Annette Hansen and Hansen, {Ib T{\o}nder} and Gina Kollerup and Louise Linde and Lindegaard, {Hanne M} and Poulsen, {Uta Engling} and Annette Schlemmer and Jensen, {Dorte Vendelbo} and Signe Jensen and Gisela Hostenkamp and Mikkel {\O}stergaard and All Departments and Hetland, {Merete Lund} and Christensen, {Ib Jarle} and Ulrik Tarp and Lene Dreyer and Annette Hansen and Hansen, {Ib T{\o}nder} and Kollerup, {Gina Birgitte} and Louise Linde and Lindegaard, {Hanne Merete} and Poulsen, {Uta Engling} and Annette Schlemmer and Jensen, {Dorte Vendelbo} and Signe Jensen and Gisela Hostenkamp and Mikkel {\O}stergaard and Mikkel {\O}stergaard",

note = "Keywords: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal; Antirheumatic Agents; Arthritis, Rheumatoid; Denmark; Female; Health Status; Humans; Immunoglobulin G; Male; Medication Adherence; Middle Aged; Prognosis; Receptors, Tumor Necrosis Factor; Registries; Remission Induction; Treatment Outcome; Young Adult",

year = "2010",

month = jan,

day = "1",

doi = "10.1002/art.27227",

language = "English",

volume = "62",

pages = "22--32",

journal = "Arthritis & Rheumatology",

issn = "2326-5205",

publisher = "Wiley",

number = "1",

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TY - JOUR

T1 - Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry

AU - Hetland, Merete Lund

AU - Christensen, Ib Jarle

AU - Tarp, Ulrik

AU - Dreyer, Lene

AU - Hansen, Annette

AU - Hansen, Ib Tønder

AU - Kollerup, Gina

AU - Linde, Louise

AU - Lindegaard, Hanne M

AU - Poulsen, Uta Engling

AU - Schlemmer, Annette

AU - Jensen, Dorte Vendelbo

AU - Jensen, Signe

AU - Hostenkamp, Gisela

AU - Østergaard, Mikkel

AU - Departments, All

AU - Hetland, Merete Lund

AU - Christensen, Ib Jarle

AU - Tarp, Ulrik

AU - Dreyer, Lene

AU - Hansen, Annette

AU - Hansen, Ib Tønder

AU - Kollerup, Gina Birgitte

AU - Linde, Louise

AU - Lindegaard, Hanne Merete

AU - Poulsen, Uta Engling

AU - Schlemmer, Annette

AU - Jensen, Dorte Vendelbo

AU - Jensen, Signe

AU - Hostenkamp, Gisela

AU - Østergaard, Mikkel

AU - All Departments of Rheumatology in Denmark

N1 - Keywords: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal; Antirheumatic Agents; Arthritis, Rheumatoid; Denmark; Female; Health Status; Humans; Immunoglobulin G; Male; Medication Adherence; Middle Aged; Prognosis; Receptors, Tumor Necrosis Factor; Registries; Remission Induction; Treatment Outcome; Young Adult

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Objective. To compare tumor necrosis factor α inhibitors directly regarding the rates of treatment response, remission, and the drug survival rate in patients with rheumatoid arthritis (RA), and to identify clinical prognostic factors for response. Methods. The nationwide DANBIO registry collects data on rheumatology patients receiving routine care. For the present study, we included patients from DANBIO who had RA (n = 2,326) in whom the first biologic treatment was initiated (29% received adalimumab, 22% received etanercept, and 49% received infliximab). Baseline predictors of treatment response were identified. The odds ratios (ORs) for clinical responses and remission and hazard ratios (HRs) for drug withdrawal were calculated, corrected for age, disease duration, the Disease Activity Score in 28 joints (DAS28), seropositivity, concomitant methotrexate and prednisolone, number of previous disease-modifying drugs, center, and functional status (Health Assessment Questionnaire score). Results. Seventy percent improvement according to the American College of Rheumatology criteria (an ACR70 response) was achieved in 19% of patients after 6 months. Older age, concomitant prednisolone treatment, and low functional status at baseline were negative predictors. The ORs (95% confidence intervals [95% CIs]) for an ACR70 response were 2.05 (95% CI 1.52-2.76) for adalimumab versus infliximab, 1.78 (95% CI 1.28-2.50) for etanercept versus infliximab, and 1.15 (95% CI 0.82-1.60) for adalimumab versus etanercept. Similar predictors and ORs were observed for a good response according to the European League Against Rheumatism criteria, DAS28 remission, and Clinical Disease Activity Index remission. At 48 months, the HRs for drug withdrawal were 1.98 for infliximab versus etanercept (95% 1.63-2.40), 1.35 for infliximab versus adalimumab (95% CI 1.15-1.58), and 1.47 for adalimumab versus etanercept (95% CI 1.20-1.80). Conclusion. Older age, low functional status, and concomitant prednisolone treatment were negative predictors of a clinical response and remission. Infliximab had the lowest rates of treatment response, disease remission, and drug adherence, adalimumab had the highest rates of treatment response and disease remission, and etanercept had the longest drug survival rates. These findings were consistent after correction for confounders and sensitivity analyses and across outcome measures and followup times.

AB - Objective. To compare tumor necrosis factor α inhibitors directly regarding the rates of treatment response, remission, and the drug survival rate in patients with rheumatoid arthritis (RA), and to identify clinical prognostic factors for response. Methods. The nationwide DANBIO registry collects data on rheumatology patients receiving routine care. For the present study, we included patients from DANBIO who had RA (n = 2,326) in whom the first biologic treatment was initiated (29% received adalimumab, 22% received etanercept, and 49% received infliximab). Baseline predictors of treatment response were identified. The odds ratios (ORs) for clinical responses and remission and hazard ratios (HRs) for drug withdrawal were calculated, corrected for age, disease duration, the Disease Activity Score in 28 joints (DAS28), seropositivity, concomitant methotrexate and prednisolone, number of previous disease-modifying drugs, center, and functional status (Health Assessment Questionnaire score). Results. Seventy percent improvement according to the American College of Rheumatology criteria (an ACR70 response) was achieved in 19% of patients after 6 months. Older age, concomitant prednisolone treatment, and low functional status at baseline were negative predictors. The ORs (95% confidence intervals [95% CIs]) for an ACR70 response were 2.05 (95% CI 1.52-2.76) for adalimumab versus infliximab, 1.78 (95% CI 1.28-2.50) for etanercept versus infliximab, and 1.15 (95% CI 0.82-1.60) for adalimumab versus etanercept. Similar predictors and ORs were observed for a good response according to the European League Against Rheumatism criteria, DAS28 remission, and Clinical Disease Activity Index remission. At 48 months, the HRs for drug withdrawal were 1.98 for infliximab versus etanercept (95% 1.63-2.40), 1.35 for infliximab versus adalimumab (95% CI 1.15-1.58), and 1.47 for adalimumab versus etanercept (95% CI 1.20-1.80). Conclusion. Older age, low functional status, and concomitant prednisolone treatment were negative predictors of a clinical response and remission. Infliximab had the lowest rates of treatment response, disease remission, and drug adherence, adalimumab had the highest rates of treatment response and disease remission, and etanercept had the longest drug survival rates. These findings were consistent after correction for confounders and sensitivity analyses and across outcome measures and followup times.

U2 - 10.1002/art.27227

DO - 10.1002/art.27227

M3 - Journal article

C2 - 20039405

SN - 2326-5205

VL - 62

SP - 22

EP - 32

JO - Arthritis & Rheumatology

JF - Arthritis & Rheumatology

IS - 1

ER -