Treatment Patterns in the First Year After Initiating Tumor Necrosis Factor Blockers in Real-World SettingsReport as inadecuate




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Advances in Therapy

, Volume 29, Issue 8, pp 664–674

First Online: 08 August 2012Received: 15 May 2012

Abstract

BackgroundTumor necrosis factor TNF-blockers are approved for use in several immune-related conditions, but treatment patterns, such as switching between TNF blockers or restarting treatment after a gap in therapy, are not clearly established. This analysis examined TNF blocker treatment patterns within the first year after initiating treatment with etanercept, adalimumab, or infliximab in patients with rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis.

MethodsAdministrative claims data from the MarketScan® Commercial Claims and Encounters Database Thomson Reuters, Ann Arbor, MI, USA were analyzed for patients with rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis who were continuously enrolled and newly initiated etanercept, adalimumab, or infliximab treatment between January 1, 2005 and July 1, 2009. Persistence no treatment gap ≥45 days, restarting index therapy after a ≥45-day treatment gap, switching to a different biologic of interest certolizumab, golimumab, ustekinumab, alefacept, abatacept, rituximab, or tocilizumab, and stopping ≥45-day treatment gap with no restart or switch were analyzed for the first year after the index date.

ResultsA total of 8,454 patients had an index claim for etanercept n = 4,224, adalimumab n = 2,941, or infliximab n = 1,289. Treatment patterns in the first year across all four conditions combined for etanercept, adalimumab, or infliximab, respectively, were: persistence, 42%, 47%, and 56%; restarting, 25%, 19%, and 12%; switching, 13%, 12%, and 13%; and stopping, 20%, 22%, and 19%. The combined rates of either persistence or restarting initial therapy after a treatment gap were 67%, 66%, and 68%, for etanercept, adalimumab, and infliximab, respectively. Most switches 66–92% were between the three TNF blockers.

ConclusionIn the first year after initiating TNF blocker therapy, patients often have a ≥45-day treatment gap; however, approximately two-thirds of patients are either persistent with or restart their index therapy in the year following TNF blocker initiation.

KeywordsAdalimumab Ankylosing spondylitis Etanercept Infliximab Psoriasis Psoriatic arthritis Rheumatoid arthritis TNF blocker Treatment gaps Treatment patterns To view enhanced content go to www.advancesintherapy.com

This article is published with open access at Springerlink.com

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Author: Machaon Bonafede - Kathleen M. Fox - Crystal Watson - Nicole Princic - Shravanthi R. Gandra

Source: https://link.springer.com/







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