Survival of biological therapy in paraguayan rheumatoid arthritis patients
Abstract
Introduction: The survival of biological therapies (BT) is considered an indirect measure of their efficacy and tolerability, which is why there is a growing interest in studying it. Currently, information on the survival of BT in Paraguayan patients with rheumatoid arthritis (RA) is limited. The development of biological therapies has allowed a better control of the inflammatory activity in rheumatoid arthritis (RA) and a greater number of patients achieve conremission. There is an increasing interest in studying the survival and efficacy of these agents in real life clinical practice. Objective: To analyze the survival of biological therapies administered to patients with RA from the Rheumatology Service of the Hospital Central del Instituto de Previsión Social (H.C.I.P.S). Methodology: Observational study of patients with RA who received biological therapies with follow-up at the Rheumatology Service of the H.C.I.P.S from January 2005 to December 2015. Survival was determined using the Kaplan Meier estimator. To analyze the effect of certain covariates, we used the Cox regression model. Results: 229 patients were included, and 258 TB were identified (adalimumab 58.1%, tocilizumab 20, 9% etanercept 18.9% and rituximab 1.9%). The mean survival of adalimumab, etanercept and tocilizumab was 246, 276 and 246 weeks respectively. In the analysis, the number of previous biological therapies was significantly associated with an increased risk of withdrawal. The number of previous biological therapies and treatment with tocilizumab were associated with an increased risk of withdrawal due to an adverse event. When analyzing the group of treatments withdrawn due to inefficacy, the number of previous biological therapies and adalimumab treatment were associated with an increased risk of discontinuation for this reason. Conclusion: In this series of Paraguayan patients with RA, the survival was greater for treatment with etanercept and variables associated with a lower survival vary according to the reason for withdrawal of treatment.
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