Introduction
Materials and methods
Patients
Statistical analysis
Results
Baseline characteristics
Variable | ABT (n = 390) | ADA (n = 374) | CZP (n = 135) | ETN (n = 616) | GLM (n = 208) | IFX (n = 650) | TCZ (n = 364) |
---|---|---|---|---|---|---|---|
Age (years) | 65.5 ± 12.4 | 55.3 ± 12.8 | 58.1 ± 16.8 | 55.5 ± 15.9 | 62.0 ± 14.8 | 52.9 ± 13.4 | 56.6 ± 14.4 |
Female sex (%) | 81.2 | 79.4 | 88.8 | 86.7 | 86.1 | 78.0 | 78.2 |
Disease duration (years) | 9.2 ± 12.4 | 5.0 ± 7.5 | 4.7 ± 7.6 | 8.3 ± 8.7 | 7.3 ± 10.0 | 6.9 ± 8.4 | 7.4 ± 9.4 |
RF positivity (%) | 86.6 | 73.8 | 86.2 | 83.1 | 75.6 | 74.2 | 74.0 |
ACPA positivity (%) | 84.3 | 75.9 | 85.7 | 83.2 | 73.2 | 82.9 | 82.1 |
DAS28-ESR | 4.4 ± 1.2 | 4.1 ± 1.2 | 4.6 ± 1.4 | 4.4 ± 1.4 | 4.3 ± 1.2 | 4.5 ± 1.6 | 4.6 ± 1.5 |
CDAI | 17.7 ± 9.6 | 14.7 ± 9.1 | 22.2 ± 12.9 | 17.3 ± 8.8 | 17.2 ± 11.5 | 18.5 ± 12.4 | 18.1 ± 9.8 |
HAQ-DI | 1.2 ± 0.8 | 0.7 ± 0.6 | 1.2 ± 0.8 | 0.9 ± 0.8 | 1.1 ± 0.8 | 1.1 ± 0.9 | 1.1 ± 0.8 |
PSL usage (%) | 44.2 | 32.8 | 44.8 | 39.2 | 38.9 | 36.4 | 45.7 |
PSL dose (mg/day) | 3.1 ± 7.3 | 2.9 ± 4.9 | 1.7 ± 2.6 | 2.8 ± 3.6 | 2.3 ± 3.6 | 3.1 ± 5.9 | 2.8 ± 3.9 |
MTX usage (%) | 49.1 | 72.0 | 76.1 | 39.4 | 76.0 | 100.0 | 51.2 |
MTX dose (mg/week) | 8.1 ± 2.8 | 9.4 ± 3.1 | 9.4 ± 2.9 | 8.0 ± 2.8 | 9.2 ± 2.9 | 8.2 ± 2.5 | 8.8 ± 3.0 |
Starting date 2001–2009 (%) | 0.0 | 13.6 | 0.0 | 40.4 | 1.0 | 60.9 | 11.5 |
Starting date 2010–2013 (%) | 35.9 | 53.7 | 12.6 | 42.0 | 40.4 | 30.2 | 47.3 |
Starting date 2014–2019 (%) | 64.1 | 32.7 | 87.4 | 17.6 | 58.7 | 8.9 | 41.2 |
Variable | ABT (n = 273) | ADA (n = 162) | CZP (n = 91) | ETN (n = 240) | GLM (n = 250) | IFX (n = 74) | TCZ (n = 487) | TOF (n = 101) |
---|---|---|---|---|---|---|---|---|
Age (years) | 61.5 ± 13.2 | 55.4 ± 14.8 | 54.1 ± 15.4 | 55.5 ± 15.7 | 60.5 ± 14.6 | 53.5 ± 12.6 | 58.1 ± 14.1 | 59.7 ± 13.6 |
Female sex (%) | 81.3 | 87.7 | 85.7 | 82.1 | 88.0 | 79.5 | 82.5 | 77.2 |
Disease duration (years) | 11.2 ± 9.3 | 9.7 ± 9.0 | 9.9 ± 9.0 | 9.4 ± 8.1 | 12.0 ± 10.2 | 10.9 ± 16.0 | 10.0 ± 8.9 | 11.0 ± 8.6 |
RF positivity (%) | 77.8 | 78.2 | 77.2 | 75.6 | 78.1 | 72.7 | 79.9 | 80.0 |
ACPA positivity (%) | 84.4 | 80.9 | 84.8 | 86.5 | 82.9 | 82.4 | 83.3 | 73.3 |
DAS28-ESR | 4.3 ± 1.3 | 3.9 ± 1.1 | 4.4 ± 1.5 | 4.1 ± 1.4 | 4.0 ± 1.4 | 4.0 ± 1.6 | 4.4 ± 1.4 | 4.3 ± 1.3 |
CDAI | 14.7 ± 9.5 | 11.9 ± 8.8 | 16.3 ± 10.8 | 13.7 ± 10.0 | 14.6 ± 10.2 | 18.9 ± 13.0 | 16.3 ± 10.3 | 19.3 ± 11.3 |
HAQ-DI | 1.1 ± 0.8 | 0.8 ± 0.7 | 1.2 ± 0.9 | 0.9 ± 0.8 | 1.1 ± 0.8 | 1.0 ± 1.0 | 1.2 ± 0.8 | 1.0 ± 0.8 |
PSL usage (%) | 55.1 | 44.1 | 40.7 | 47.0 | 46.0 | 42.5 | 52.2 | 54.5 |
PSL dose (mg/day) | 6.4 ± 4.1 | 5.9 ± 4.3 | 4.9 ± 2.9 | 5.6 ± 3.8 | 5.1 ± 3.5 | 5.6 ± 3.1 | 6.1 ± 3.9 | 4.1 ± 3.1 |
MTX usage (%) | 47.8 | 57.1 | 62.6 | 50.0 | 66.1 | 100.0 | 54.9 | 51.5 |
MTX dose (mg/week) | 8.4 ± 3.0 | 8.0 ± 2.9 | 8.4 ± 3.1 | 8.3 ± 2.7 | 8.0 ± 3.1 | 8.7 ± 2.8 | 8.4 ± 3.1 | 9.0 ± 3.3 |
Starting date 2001–2009 (%) | 0.0 | 25.3 | 0.0 | 27.5 | 0.0 | 20.3 | 10.9 | 0.0 |
Starting date 2010–2013 (%) | 43.2 | 49.4 | 26.4 | 37.5 | 48.8 | 51.4 | 45.8 | 2.0 |
Starting date 2014–2019 (%) | 56.8 | 25.3 | 73.6 | 35.0 | 51.2 | 28.4 | 43.3 | 98.0 |
2nd bio or TOF (%) | 54.6 | 75.9 | 41.8 | 74.6 | 58.8 | 70.3 | 57.3 | 31.7 |
≥ 3rd bio or TOF (%) | 45.4 | 24.1 | 58.2 | 25.4 | 41.2 | 29.7 | 42.7 | 68.3 |
Drug retention and causes for discontinuation
Reference | HR (95% CI) | |||||||
---|---|---|---|---|---|---|---|---|
Variable | ABT (n = 390) | ADA (n = 374) | CZP (n = 135) | ETN (n = 616) | GLM (n = 208) | IFX (n = 650) | TCZ (n = 364) | P value |
Lack of effectiveness | 1 | 1.4 (1.0–2.1) | 2.4 (1.5–3.8)*** | 1.7 (1.2–2.4)** | 1.1 (0.7–1.7) | 1.5 (1.1–2.2)* | 1.1 (0.8–1.7) | < 0.001 |
All toxic adverse events | 1 | 2.8 (1.5–5.2)*** | 1.7 (0.7–4.0) | 4.0 (2.3–6.9)*** | 2.5 (1.3–4.8)** | 4.3 (2.5–7.3)*** | 2.2 (1.2–4.2)* | < 0.001 |
Non-toxic reasons | 1 | 0.8 (0.5–1.3) | 0.3 (0.1–0.9)* | 1.1 (0.7–1.6) | 1.5 (0.9–2.5) | 1.0 (0.7–1.5) | 1.1 (0.7–1.8) | 0.07 |
Remission | 1 | 2.9 (1.5–5.4)*** | 1.8 (0.8–4.4) | 1.0 (0.5–2.0) | 2.4 (1.2–5.0)* | 3.1 (1.7–5.6)*** | 2.5 (1.3–4.8) ** | < 0.001 |
All adverse events (including lack of effectiveness and toxic adverse events) | 1 | 1.8 (1.3–2.5)*** | 2.5 (1.6–3.7) *** | 2.3 (1.7–3.1)*** | 1.5 (1.0–2.2)* | 2.1 (1.6–2.9)*** | 1.4 (1.0–2.0)* | < 0.001 |
Reference | HR (95% CI) | ||||||||
---|---|---|---|---|---|---|---|---|---|
Variable | ABT (n = 273) | ADA (n = 162) | CZP (n = 91) | ETN (n = 240) | GLM (n = 250) | IFX (n = 74) | TCZ (n = 487) | TOF (n = 101) | P value |
Lack of effectiveness | 1 | 1.3 (0.9–1.8) | 1.5 (1.0–2.2)* | 1.1 (0.8–1.5) | 1.0 (0.7–1.3) | 1.3 (0.9–2.0) | 0.6 (0.4–0.8)*** | 0.8 (0.5–1.2) | < 0.001 |
All toxic adverse events | 1 | 1.8 (1.0–3.1) | 0.8 (0.3–2.0) | 0.4 (0.2–0.9)* | 1.0 (0.6–1.9) | 1.2 (0.5–2.7) | 1.4 (0.9–2.3) | 1.8 (0.9–3.5) | 0.004 |
Non-toxic reasons | 1 | 1.2 (0.6–2.2) | 0.3 (0.1–1.1) | 0.8 (0.4–1.4) | 0.8 (0.4–1.5) | 0.9 (0.4–2.4) | 0.8 (0.5–1.3) | 0.6 (0.2–1.5) | 0.5 |
Remission | 1 | 0.8 (0.1–5.0) | 0.9 (0.1–9.2) | 1.4 (0.3–6.1) | 1.8 (0.4–7.7) | 1.9 (0.4–10.7) | 1.5 (0.4–5.4) | 2.3 (0.4–13.8) | 0.9 |
All adverse events (including lack of effectiveness and toxic adverse events) | 1 | 2.7 (1.6–4.3)*** | 2.2 (1.4–3.4)** | 1.2 (0.8–2.0) | 1.4 (1.0–2.1) | 2.0 (1.0–3.7)* | 0.9 (0.6–1.4) | 1.1 (0.6–1.9) | < 0.001 |