Predictors of first TNFi discontinuation over a maximum of 5 years of follow-up in 9139 Swedish patients with rheumatoid arthritis*
| Unadjusted HR (95% CI) | p Value | Adjusted HR (95% CI) | p Value | |
|---|---|---|---|---|
| Age (per 10 years) | 1.06 (1.03 to 1.08) | <0.001 | 1.02 (0.99 to 1.05) | 0.13 |
| Women | 1.16 (1.07 to 1.25) | <0.001 | 1.12 (1.04 to 1.21) | 0.004 |
| Men | 1.00 (ref) | 1.00 (ref) | ||
| Education level | ||||
| <9 years | 1.20 (1.10 to 1.32) | <0.001 | 1.14 (1.04 to 1.25) | <0.001 |
| 10–12 years | 1.22 (1.12 to 1.32) | <0.001 | 1.20 (1.10 to 1.30) | |
| >12 years | 1.00 (ref) | 1.00 (ref) | ||
| Missing | 1.15 (0.91 to 1.46) | 0.23 | 1.06 (0.83 to 1.34) | |
| Period | ||||
| 2003–2005 | 1.00 (ref) | 0.15 | 1.00 (ref) | <0.001 |
| 2006–2009 | 1.06 (0.99 to 1.14) | 1.13 (1.06 to 1.21) | ||
| 2010–2011 | 1.09 (0.98 to 1.21) | 1.20 (1.10 to 1.30) | ||
| HAQ at baseline | <0.001 | <0.001 | ||
| <1 | 1.00 (ref) | 1.00 (ref) | ||
| 1–1.49 | 1.21 (1.11 to 1.32) | 1.19 (1.09 to 1.30) | ||
| 1.5–1.9 | 1.29 (1.18 to 1.42) | 1.22 (1.11 to 1.34) | ||
| ≥2 | 1.42 (1.28 to 1.57) | 1.26 (1.13 to 1.41) | ||
| Missing | 1.09 (0.97 to 1.22) | 0.97 (0.86 to 1.09) | ||
| Concomitant drug use | ||||
| Non-biological DMARDs | 0.78 (0.72 to 0.84) | <0.001 | 0.78 (0.72 to 0.84) | <0.001 |
| No non-biological DMARDs | 1.00 (ref) | 1.00 (ref) | ||
| General patient frailty† | ||||
| Hospital days (per 10) | 1.07 (1.04 to 1.09) | <0.001 | 1.04 (1.01 to 1.06) | 0.002 |
| Outpatient visits (per 10) | 1.14 (1.10 to 1.18) | <0.001 | 1.13 (1.09 to 1.17) | <0.001 |
*Cox regression models performed by strata defined by biological drug; HRs >1 indicate more likely to discontinue first TNFi.
†Assessed during the 2 years preceding TNFi initiation. Data on hospital days and non-primary outpatient care visits retrieved from the Swedish National Patient Register between 2001 and 2009.
DMARD, disease modifying antirheumatic drug; HAQ, health assessment questionnaire; TNFi, tumour necrosis factor inhibitor.