Introduction:
Inflammatory arthritis is related to disability, chronic pain, and premature
death. A lack of treatment persistence leads to poor control of symptoms, inflammation,
and joint damage, thereby worsening quality of life.
Objective: To
determine the effectiveness of antirheumatic drug treatment and the persistence
of use in Colombian patients diagnosed with rheumatoid arthritis (RA),
psoriatic arthritis (PsA), ankylosing spondyloarthritis (AS), and juvenile
rheumatoid arthritis (JIA) after the failure of conventional disease-modifying
antirheumatic drugs. (cDMARDs).
Methods: In this retrospective
descriptive study, patients who were diagnosed with RA, PsA, AS, or JIA; were
treated at a center specializing in rheumatological diseases; who started their
first treatment with biological DMARDs (bDMARDs) or tofacitinib between
February 2016 and December 2019; and who were followed up until the
discontinuation of treatment or 24 months were evaluated.
Results: A total of 426
patients were included; 78.8% were women, and the mean age was 50.2±14.1 years.
The majority had a diagnosis of RA (71.8%). A total of 89.9% had received
cDMARDs, and 77.2% had received glucocorticoids. The most frequently initiated
bDMARDs were rituximab (31.2%), etanercept (23.0%), and adalimumab (14.6%). A
total of 80.3% of patients received concomitant cDMARDs. During an average
follow-up of 635.2±189.6 days, 12.9% of patients had changes in their treatment
regimen, 26.3% had interruptions in their treatment regimen, and 23.9%
discontinued bDMARDs or tofacitinib. Patients who received concomitant cDMARDs
were more likely to continue their biological therapy (odds ratio: 8.50; 95% confidence
interval: 3.49-20.73; p<0.001).
Conclusions: Follow-up
evaluation of this group of patients revealed that they were treated mainly
with non-TNF-α inhibitors associated with cDMARDs, and a low proportion of the
patients had changes in therapy, although one-quarter had treatment interruptions
or discontinuations.