Neycheva Stefka, Naseva Emilia, Batalov Zguro, Karalilova Rositsa
Department of Rheumatology, Military Medical Academy, MHAT - Sofia, 3 Sveti Georgi Sofiyski str, Sofia, 1606, Bulgaria.
Faculty of Public Health "Prof. Tsekomir Vodenicharov MD, DSc", Medical University of Sofia, 8 Byalo more str, Sofia, 1527, Bulgaria.
Rheumatol Int. 2024 Dec 23;45(1):6. doi: 10.1007/s00296-024-05752-9.
Rheumatoid arthritis is a progressive disease that requires continuous treatment. Despite the excellent results, treatment with biologics and target-specific disease-modifying anti-rheumatic drugs often has to be interrupted due to insufficient therapeutic effectiveness, toxicity, or side effects.
The purpose of this study is to identify the reasons and factors influencing treatment discontinuation with biologic and target-specific drugs among the Bulgarian patients with rheumatoid arthritis.
This is a single-centre, retrospective observational cohort study, that includes 154 patients with seropositive rheumatoid arthritis, who underwent a total of 221 therapeutic courses with biologic and target-specific drugs over a period of 12 years.
Out of the 221 therapeutic courses, 103 (46.6%) were discontinued. Due to an initial lack of efficacy, treatment was interrupted in 38 of cases (36.9%). A secondary lack of efficacy led to the discontinuation of 24 treatment regimens (23.3%). Allergic reactions and "other" reasons necessitated the cessation of therapy in 41 cases (39.8%). The male gender (HR = 2.111; 95%CI 1.261-3.535), age below 59 years (HR = 1.791, 95%CI 1.162-2.760), shorter disease duration (HR = 0.995, 95%CI 0.993-0.998), co-morbidity with diabetes mellitus (HR = 3.463, 95%CI 1.189-10.090), cerebrovascular disease (HR = 2.490, 95%CI 1.215-5.102), and the type of medication were identified as factors influencing the interruption of treatment. Age (p = 0.012), disease duration (р=0.06), and therapy duration (р<0.01) have a significant impact on the reasons for treatment discontinuation.
Awareness of the reasons and factors influencing the discontinuation of treatment with biologic and target-specific drugs is crucial for improving existing therapeutic strategies and developing futures ones.
类风湿性关节炎是一种需要持续治疗的进展性疾病。尽管治疗效果良好，但生物制剂和靶向性改善病情抗风湿药物的治疗常常因治疗效果不佳、毒性或副作用而不得不中断。
本研究旨在确定影响保加利亚类风湿性关节炎患者停用生物制剂和靶向性药物治疗的原因和因素。
这是一项单中心回顾性观察队列研究，纳入了154例血清阳性类风湿性关节炎患者，他们在12年期间共接受了221个疗程的生物制剂和靶向性药物治疗。
在221个治疗疗程中，103个（46.6%）被中断。由于最初缺乏疗效，38例（36.9%）治疗被中断。继发性疗效不佳导致24个治疗方案（23.3%）中断。过敏反应和“其他”原因导致41例（39.8%）治疗停止。男性（HR = 2.111；95%CI 1.261 - 3.535）、年龄低于59岁（HR = 1.791，95%CI 1.162 - 2.760）、病程较短（HR = 0.995，95%CI 0.993 - 0.998）、合并糖尿病（HR = 3.463，95%CI 1.189 - 10.090）、脑血管疾病（HR = 2.490，95%CI 1.215 - 5.102）以及药物类型被确定为影响治疗中断的因素。年龄（p = 0.012）、病程（р = 0.06）和治疗持续时间（р < 0.01）对治疗中断原因有显著影响。
了解影响生物制剂和靶向性药物治疗中断的原因和因素对于改进现有治疗策略和制定未来治疗策略至关重要。
