Background Studies about factors for drug survival for patients with AS have not sufficient as compared with RA patients and only a few studies are available for the Asian population.
Objectives To evaluate drug survival of the tumor necrosis factor-α inhibitors (TNFi) and risk factors for the drug discontinuation in patients with ankylosing spondylitis (AS).
Methods We retrospectively evaluated 487 AS patients at a single tertiary hospital. Among the TNFi users, drug survival and risk factors of TNFi discontinuation were investigated.
Results Among 487 patients, 128 AS patients were treated with at least one TNFi. Patients who were treated with TNFi were younger at disease onset, had more peripheral manifestations, and had higher level of acute phase reactants and BMI than those of TNFi non-users at baseline. Of 128 patients, 28 (21.9%) patients discontinued first TNFi therapy during the follow-up period of 65.1 ± 27.9 months. In the multivariable analysis, female (HR 6.08, 95% CI 2.27–16.27, p=0.003), hip involvement (HR 2.52, 95% CI 1.08–5.87, p=0.033) and a high CRP (HR 1.10, 95% CI 1.00–1.21, p=0.044) were risk factors for drug discontinuation. Etanercept showed better survival rate than infliximab. The main reason for discontinuation of TNFi was inefficacy.
Conclusions About one fifth of patients with AS discontinued their first TNFi. Female sex, hip involvement, CRP, and the type of TNFi were associated with TNFi discontinuation.
Disclosure of Interest None declared
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