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Experience with tofacitinib in Canada: patient characteristics and treatment patterns in rheumatoid arthritis over 3 years.
- Source :
-
Rheumatology . Mar2020, Vol. 59 Issue 3, p568-574. 7p. 2 Graphs. - Publication Year :
- 2020
-
Abstract
- Objectives To describe characteristics, treatment patterns and persistence in patients with RA treated with tofacitinib, an oral Janus kinase inhibitor, in Canadian clinical practice between 1 June 2014 and 31 May 2017. Methods Data were obtained from the tofacitinib eXel support programme. Baseline demographics and medication history were collected via patient report/special authorization forms; reasons for discontinuation were captured by patient report. Treatment persistence was estimated using Kaplan–Meier methods, with data censored at last follow-up. Cox regression was applied to analyse baseline characteristics associated with treatment discontinuation. Results The number of patients with RA enrolled from 2014 to 2017 was 4276; tofacitinib utilization increased during that period, as did the proportion of biologic (b) DMARD-naïve patients prescribed tofacitinib. Of patients who initiated tofacitinib, 1226/3678 (33.3%) discontinued, mostly from lack of efficacy (35.7%) and adverse events (26.9%). Persistence was 62.7% and 49.6% after 1 and 2 years of treatment, respectively. Prior bDMARD experience predicted increased tofacitinib discontinuation (vs bDMARD-naïve, P < 0.001). Increased retention was associated with older age (56–65 years and >65 years vs ⩽45 years; P < 0.05), and time since diagnosis of 15 to <20 years (vs <5 years; P < 0.01). In bDMARD-naïve, post-1 bDMARD, post-2 bDMARD and post-⩾3 bDMARD patients, median survival was >730, 613, 667 and 592 days, respectively. Conclusion Since 2014, tofacitinib use in Canadian patients with RA increased, especially among bDMARD-naïve/post-1 bDMARD patients. Median drug survival was ∼2 years. Likelihood of persistence increased for bDMARD-naïve (vs bDMARD-experienced) patients and those aged ⩾56 (vs ⩽45) years. [ABSTRACT FROM AUTHOR]
- Subjects :
- *AGE distribution
*ANTIRHEUMATIC agents
*DRUGS
*DRUG side effects
*MEDICAL records
*NEUROTRANSMITTER uptake inhibitors
*PATIENT compliance
*RHEUMATOID arthritis
*THERAPEUTICS
*PHYSICIAN practice patterns
*TERMINATION of treatment
*PROPORTIONAL hazards models
*DESCRIPTIVE statistics
*KAPLAN-Meier estimator
*ACQUISITION of data methodology
*JANUS kinases
Subjects
Details
- Language :
- English
- ISSN :
- 14620324
- Volume :
- 59
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 141923323
- Full Text :
- https://doi.org/10.1093/rheumatology/kez324