The unadjusted persistence rates and adjusted likelihood of drug discontinuation based on anti-TNFα switching status*
| Persistence rate | ||||
|---|---|---|---|---|
| 12 months (95% CI) | 24 months (95% CI) | Adjusted HR (95% CI) | p Value | |
| TNF inhibitor switching status | ||||
| Biologically naive (referent) | 72% (70% to 75%) | 57% (54% to 60%) | 1 | |
| First switchers | 60% (55% to 64%) | 42% (37% to 47%) | 1.42 (1.22 to 1.67) | <0.001 |
| Second switchers | 63% (54% to 70%) | 42% (33% to 51%) | 1.35 (1.03 to 1.76) | 0.028 |
| Interdrug comparisons | ||||
| Biologically naive | ||||
| Infliximab (referent) | 76% (72% to 80%) | 63% (58% to 67%) | 1 | |
| Adalimumab | 68% (64% to 73%) | 53% (47% to 58%) | 1.42 (1.12 to 1.80) | 0.004 |
| Etanercept | 72% (68% to 76%) | 53% (48% to 59%) | 1.27 (1.00 to 1.61) | 0.047 |
| First switchers | ||||
| Infliximab (referent) | 65% (56% to 72%) | 43% (34% to 52%) | 1 | |
| Adalimumab | 57% (51% to 62%) | 42% (35% to 48%) | 1.14 (0.84 to 1.55) | NS |
| Etanercept | 60% (50% to 68%) | 41% (31% to 50%) | 1.01(0.71 to 1.44) | NS |
* Results are presented as HR with 95% CI in parentheses; the models adjusted for age, gender, patient and provider assessments of disease activity, self-reported disability, comorbidity, methotrexate use and year of anti-TNF initiation.
NS, not significant; TNF, tumour necrosis factor.