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Treatment Adherence and Adherence Patterns of Tofacitinib and Self-Injectable TNFi Use in People with Rheumatoid
Kaleb Michaud1, Sofia Pedro2, Eric Tousset3
1University of Nebraska Medical Center, Omaha, and Forward Databank, Wichita, KS.
ACR Open Rheumatology
|December 2, 2023
Summary
Adherence to tofacitinib and self-injectable tumor necrosis factor inhibitors (TNFi) in rheumatoid arthritis (RA) patients was similar, with no significant differences. Concomitant methotrexate, patient global assessment, and consistent daily intake influenced adherence.
Area of Science:
- Rheumatology
- Pharmacology
- Patient Adherence Studies
Background:
- Rheumatoid arthritis (RA) management often involves targeted therapies like tofacitinib and tumor necrosis factor inhibitors (TNFi).
- Assessing medication adherence is crucial for treatment efficacy and patient outcomes in chronic conditions like RA.
Purpose of the Study:
- To evaluate and compare adherence rates between tofacitinib and self-injectable TNFi in RA patients.
- To identify factors associated with medication adherence in this patient population.
Main Methods:
- Utilized the Medication Event Monitoring System (MEMS) and patient diaries to track dosing over 9 months.
- Enrolled patients initiating tofacitinib or injectable TNFi within 6 months of prescription.
- Collected demographic, disease characteristics, and medication beliefs data.
Main Results:
- No statistically significant differences in adherence (77% tofacitinib vs. 70% TNFi) or implementation (0.84 vs. 0.82) were observed at 9 months.
- Concomitant methotrexate (MTX) adherence was higher with tofacitinib, leading to initially higher combined adherence.
- Increased patient global assessment was linked to higher discontinuation rates.
Conclusions:
- Tofacitinib and self-injectable TNFi demonstrated comparable adherence in RA patients, though a notable percentage (15-30%) were nonadherent.
- Concomitant MTX use, patient-reported global disease assessment, and consistent daily intake timing were associated with improved adherence.
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