Ankylosing Spondylitis Women Show Less Durable Responses to TNF Inhibitors Save

A study from the Netherlands has shown that the long-term drug survival of TNF inhibitors differ between men and women, with women having a lower long-term retention rate compared to men. (Citation source: http://bit.ly/2KZQ0DJ)
A single-center, retrospective study of 122 anklylosing spondylitis (AS) patients, analyzed the outcomes of those receiving either etanercept, adalimumab, or infliximab between 2004 and 2014.
Nearly 40% were women and most AS patients received adalimumab (59.7%), compared to etanercept (28.9%) or infliximab (11.3%).
This 10-year analysis (mean follow-up duration was 5.1 years) showed several interesting results:
- the best TNFi survival rate with etanercept (85.3% after 3.7 years), followed by adalimumab and infliximab.
- 17.2% eventually stopped TNFi without starting a new therapy,
- 26.2% stopped their TNFi and then switched to another anti-TNF agent.
- TNFi discontinuation were due to inefficacy (52.4%), vollowed by adverse events, especially infections.
- Women had significantly lower treatment survival than men (women 33.4 mos versus men 44.9 mos (P = .031)
- Women switched to another drugy more frequently than men (26.9% vs 16.3%)
- Women were more likely to completely stop anti-TNF therapy (vs. men) (20.8% vs 14.9%, not significant).
Factors that drive these differences will require further study.
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