Friday, 25 May 2018

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Ankylosing Spondylitis Women Show Less Durable Responses to TNF Inhibitors

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. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

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