Low rates of adherence for tumor necrosis factor-α inhibitors in Crohn’s disease and rheumatoid arthritis: Results of a systematic review

Fidder, Herma H.; Singendonk, Maartje; Have, Mike van der; Oldenburg, Bas; Oijen, Martijn G.H. van

doi:10.3748/wjg.v19.i27.4344

Cited by 67 publications

(67 citation statements)

References 29 publications

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“…Three studies showed that in CD the adherence rate for infliximab (72%) was higher compared to that of adalimumab (55%), with a relative risk of 1.61 (95% CI: 1.27–2.03), whereas in RA adherence to adalimumab (67%) was higher compared to that of infliximab (48%) and etanercept (59%), with a relative risk of 1.41 (95% CI, 1.3–1.52) and 1.13 (95% CI, 1.10–1.18), respectively. In another comparative study, the RA adherence to infliximab was higher than with etanercept and adalimumab 33. In contrast, in a Swiss observational cohort of patients with RA (N=2,364) treated with at least one course of anti-TNF therapy from 1997 to 2006, the discontinuation rate was significantly higher among patients treated with infliximab compared with those treated with etanercept or adalimumab 34…”

Section: Discussionmentioning

confidence: 92%

Adherence and resource use among patients treated with biologic drugs: findings from BEETLE study

Esposti¹,

Sangiorgi²,

Perrone³

et al. 2014

CEOR

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ObjectivesSystemic administration of anti-tumor necrosis factor alpha (anti-TNF alpha) leads to an anti-inflammatory and joint protective effect in pathologies such as rheumatoid arthritis, psoriasis, and Crohn’s disease. The aim of this study was to assess adherence to therapy, persistence in treatment (no switches or interruptions), and consumption of care resources (drugs, outpatient services, hospitalizations).MethodsWe conducted an observational retrospective cohort analysis using the administrative databases of five local health units. Patients filling at least one prescription for anti-TNF alpha between January 1, 2009 and December 31, 2011 were included and followed up for 1 year. Patients were defined as adherent if >80% of the follow-up period was covered by drugs dispensation.ResultsA total of 1,219 patients were analyzed (mean age 49.6±14.6, male 47%). Among enrolled patients, 36% were affected by rheumatoid arthritis, and 31% and 10% were affected by psoriasis and Crohn’s disease, respectively; other indications remained below these percentages. Thirty-four percent of patients (420) were treated with adalimumab, 51% (615) with etanercept, and 15% (184) with infliximab. Among the 94% of patients who did not switch, those treated with infliximab had a higher rate of adherence across all indications (51% overall) when compared to that observed in patients treated with etanercept (27%) or adalimumab (23%). The mean annual nonpharmacological expenditure for each patient in analysis was €988 for adherent and €1,255 for nonadherent patients. Infliximab was associated with the lowest cost for all indications as determined by the multivariate generalized linear model.ConclusionsPatients treated with infliximab were associated with higher adherence and persistence in treatment and lower costs, as compared to those treated with adalimumab or etanercept.

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Section: Discussionmentioning

confidence: 92%

Adherence and resource use among patients treated with biologic drugs: findings from BEETLE study

Esposti¹,

Sangiorgi²,

Perrone³

et al. 2014

CEOR

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“…Além disso, poucos estudos avaliaram os MMCD biológicos adalimumabe e etanercepte 6,12,23 . Em uma revisão sistemática que incluiu estudos com pacientes em uso de biológicos anti-TNF para o tratamento da artrite reumatoide 24 , foi encontrada uma taxa semelhante de não adesão, ou seja, de um terço. O estudo de Li et al 11 foi o que encontrou maior taxa de não adesão em pacientes portadores de artrite reumatoide, sendo de 68% para o etanercepte.…”

Section: Discussionunclassified

“…Fidder et al 24 , em revisão sistemática de adesão a medicamentos biológicos na artrite reumatoide, encontraram que o sexo feminino foi o fator mais fortemente associado à ocorrên-cia de não adesão. Curkendall et al 6 também encontraram associação do sexo feminino à alta taxa de não adesão aos biológicos adalimumabe e etanercepte.…”

Section: Discussionunclassified

Não adesão à terapia biológica em pacientes com doenças reumáticas no Sistema Único de Saúde em Minas Gerais, Brasil

2015

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Resumo Neste estudo, buscou-se estimar e analisar fatores associados à não adesão ao tratamento com os medicamentos biológicos adalimumabe e etanercepte em pacientes portadores de doenças reumáticas atendidos pelo Sistema Único de Saúde de Minas Gerais, Brasil. Procedeu-se a estudo prospectivo não concorrente com base no registro de dispensação nas farmácias de pacientes adultos em início de tratamento. A taxa de não adesão foi estimada com utilização do método de proporção de dias cobertos (PDC), sendo considerados não aderentes pacientes com PDC < 0,8. Foram identificados 1.150 pacientes, sendo 64,3% portadores de artrite reumatoide, 8,5% de artrite psoriásica e 27,2% de espondilite anquilosante. A taxa de não adesão encontrada foi de 33,5% e os fatores associados foram idade entre 19-39 anos, sexo feminino, diagnóstico de artrite reumatoide e início de tratamento com etanercepte. Os resultados indicam uma alta taxa de não adesão ao tratamento, que pode originar piores resultados em saúde e implicar o aumento da utilização de cuidados e dos custos em saúde.

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“…For subcutaneously administrated medication non-adherence rates up to 53.1% are reported [102]. Also, a systematic review comparing intravenous versus subcutaneous administration in the IBD and rheumatologic population showed higher non-adherence rates to subcutaneous medication [39]. Oral administration could overcome this problem even though this will require further investigations, as adherence to oral 5-ASA is low in the long-term.…”

Section: The Future Of Anti-tnf Therapymentioning

confidence: 90%

“…Indeed, mainly necessity belief, safety concerns and the quality of patient-physician relationship, and not the route of administration, influence drug adherence. Nevertheless, data from the literature remain conflicting, and higher non-adherence rates to subcutaneously administrated therapy are reported [39].…”

Section: Which Anti-tnf Agent To Choose?mentioning

confidence: 97%

Considerations, challenges and future of anti-TNF therapy in treating inflammatory bowel disease

Pouillon

Bossuyt

Peyrin–Biroulet

2016

Expert Opinion on Biological Therapy

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Low rates of adherence for tumor necrosis factor-α inhibitors in Crohn’s disease and rheumatoid arthritis: Results of a systematic review

Abstract: One-third of both CD and RA patients treated with TNF-α inhibitors are non-adherent. Female gender was consistently identified as a negative determinant of adherence.

Cited by 67 publications

References 29 publications

Adherence and resource use among patients treated with biologic drugs: findings from BEETLE study

Adherence and resource use among patients treated with biologic drugs: findings from BEETLE study

Não adesão à terapia biológica em pacientes com doenças reumáticas no Sistema Único de Saúde em Minas Gerais, Brasil

Considerations, challenges and future of anti-TNF therapy in treating inflammatory bowel disease

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