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Drug Retention of First-Line Biologic Therapies in Rheumatoid Arthritis: Real-World Evidence From a Moroccan Cohort
El Marbouh El Kacem1, Abderrahim Majjad1, Wissal Belhadj2
1Rheumatology, Mohammed V Military Training Hospital, Rabat, MAR.
Cureus
|June 10, 2026
Summary
In rheumatoid arthritis (RA), non-TNF biologics like Etanercept, Rituximab, and Tocilizumab showed better drug retention than Adalimumab in a Moroccan study. Clinical and educational factors also influenced treatment persistence.
Area of Science:
- Rheumatology
- Pharmacology
- Real-world evidence
Background:
- Drug retention is a key measure of biologic therapy effectiveness and tolerability in rheumatoid arthritis (RA).
- Data on biologic treatment persistence in North African populations are limited.
- Sociocultural factors influencing RA treatment adherence are underexplored.
Purpose of the Study:
- To evaluate drug retention rates for first-line biologic therapies in RA patients in Morocco.
- To identify clinical and sociocultural factors associated with treatment persistence.
Main Methods:
- Retrospective observational study of 130 RA patients initiating first-line biologics.
- Kaplan-Meier analysis and log-rank tests compared drug retention across different biologics.
- Cox proportional hazards regression identified predictors of treatment discontinuation.
Main Results:
- Drug retention varied significantly among biologics (p=0.018).
- Etanercept, Rituximab, and Tocilizumab demonstrated superior retention compared to Adalimumab (HRs < 0.3, p < 0.01).
- Concomitant csDMARD use, lower baseline SDAI, and primary education were linked to better retention.
Conclusions:
- Non-TNF biologics showed favorable retention over Adalimumab in this Moroccan RA cohort.
- Treatment persistence is influenced by biologic choice, disease activity, and educational background.
- Findings highlight the importance of real-world data and sociocultural context in RA management.
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