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Changing patterns of tumor necrosis factor inhibitor use in 9074 patients with rheumatoid arthritis

Yusuf Yazici1, Svetlana Krasnokutsky, Jaime P Barnes

  • 1ew York University Hospital for Joint Diseases, New York, New York 10003, USA. yusuf.yazici@nyumc.org

The Journal of Rheumatology
|April 1, 2009
PubMed
Abstract

Insights

Rheumatoid arthritis patients increasingly switch tumor necrosis factor (TNF) inhibitors. Real-world data show shorter treatment durations and about 50% continuation at two years, differing from clinical trials.

Area of Science:

  • Rheumatology
  • Pharmacology
  • Health Services Research

Background:

  • Rheumatoid arthritis (RA) management often involves switching tumor necrosis factor (TNF) inhibitors due to inadequate disease control.
  • Existing evidence for switching TNF inhibitors primarily comes from limited, short-term studies.

Purpose of the Study:

  • To analyze real-world patterns of TNF inhibitor use in RA patients.
  • To investigate dose escalation, discontinuation times, and switching behaviors among TNF inhibitors.

Main Methods:

  • Retrospective analysis of a US insurance claims database (2000-2005).
  • Examined TNF inhibitor usage, time to switch, dose escalation, and continuation rates in RA patients.

Main Results:

  • Over 9,000 RA patients initiated TNF inhibitors between 2000-2005.
  • Infliximab demonstrated the longest continuation (approx. 50% at 2 years) and higher dose escalation rates.
  • Time to switching TNF inhibitors decreased significantly from 2000 to 2005.

Conclusions:

  • TNF inhibitor use patterns evolved, showing more frequent switches and shorter treatment durations over time.
  • Real-world continuation rates (approx. 50% at 2 years) highlight discrepancies with clinical trial data.

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