Factors associated with withdrawal of the anti-TNFα biologics in the treatment of rheumatic diseases: Data from the Hong Kong Biologics Registry

Chi Chiu Mok; Ka Yan Chan; Ka Lai Lee; Lai Shan Tam; Ka Wing Lee; Eric Yuk Tat Chan; Ka Ho Chan; Ka Man Chan; Ka Yan Helen Chan; Pui Shan Julia Chan; Yee Ki Chan; Shuk Yi Lucia Chau; Tak Cheong Cheung; Tsang Cheung; Ho Yin Chung; Carmen Ho; Emily Kun; Lai Wa Kwok; Man Leung Kwok; Kitty Kwok; Chi Kwai Lam; Weng Ng Lao; Chak Sing Lau; Yu Lung Lau; Anthony Kai Yiu Lee; Tony Kwok Fai Lee; Kwok Kei Lee; Man Yee Jolly Lee; Shui Shan Lee; Tsz Leung Lee; Tsz Yan; Samson Lee; Man Chi Leung; Wai Ling Li; Hor Ming Liu; Ming Chi Luk; Kai Yiu Ma; Lai Wo Mak; Mo Yin Mok; Kam Hung Daniel Ng; Woon Leung Ng; Ho So; Chi Keung Sung; Ronald F. Tan; Shuk Kuen Sandy Tang; Man Choi Wan; Ching Han Wong; Kong Chiu Wong; Shiu Man; Pui Yan Wong; Jude Wong; Woon Sing Raymond Wong; Wai Shan Sandy Woo; Kit Yu Young; Cheuk Wan Yim; Ka Lung Carrel Yu; Ka Yan Catherine Yuen; Ka Man Amy Yung

doi:10.1111/1756-185X.12264

Factors associated with withdrawal of the anti-TNFα biologics in the treatment of rheumatic diseases: Data from the Hong Kong Biologics Registry

Chi Chiu Mok^*, Ka Yan Chan, Ka Lai Lee, Lai Shan Tam, Ka Wing Lee, Eric Yuk Tat Chan, Ka Ho Chan, Ka Man Chan, Ka Yan Helen Chan, Pui Shan Julia Chan, Yee Ki Chan, Shuk Yi Lucia Chau, Tak Cheong Cheung, Tsang Cheung, Ho Yin Chung, Carmen Ho, Emily Kun, Lai Wa Kwok, Man Leung Kwok, Kitty KwokChi Kwai Lam, Weng Ng Lao, Chak Sing Lau, Yu Lung Lau, Anthony Kai Yiu Lee, Tony Kwok Fai Lee, Kwok Kei Lee, Man Yee Jolly Lee, Shui Shan Lee, Tsz Leung Lee, Tsz Yan, Samson Lee, Man Chi Leung, Wai Ling Li, Hor Ming Liu, Ming Chi Luk, Kai Yiu Ma, Lai Wo Mak, Mo Yin Mok, Kam Hung Daniel Ng, Woon Leung Ng, Ho So, Chi Keung Sung, Ronald F. Tan, Shuk Kuen Sandy Tang, Man Choi Wan, Ching Han Wong, Kong Chiu Wong, Shiu Man, Pui Yan Wong, Jude Wong, Woon Sing Raymond Wong, Wai Shan Sandy Woo, Kit Yu Young, Cheuk Wan Yim, Ka Lung Carrel Yu, Ka Yan Catherine Yuen, Ka Man Amy Yung

^*Corresponding author for this work

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

25 Citations (Scopus)

Abstract

Objectives: To study the factors associated with withdrawal of the and tumor necrosis factor alpha (anti-TNFα) biologics in the treatment of rheumatic diseases. Method: Data from the Hong Kong Biologics Registry were retrieved. The cumulative rates of withdrawal of different biological agents were studied by Kaplan-Meier plot and the incidence of serious adverse events (SAEs) was calculated. Factors associated with the withdrawal of the anti-TNFα agents were studied by Cox regression. Results: Between 2005 and 2013, 2059 courses of biologics were used in 1345 patients. After 3454 patient-years, 1171 (57%) courses were terminated because of clinical inefficacy (38.1%), SAEs (22.3%) and financial reasons (15.9%). The most frequent SAEs (per 100-patient-years) were allergy (2.90), serious infections (1.34), tuberculosis (0.93) and infusion/injection site reaction (0.75). Among the anti-TNFα agents, the cumulative probability of drug withdrawal for either inefficacy or SAEs in 5 years was highest with infliximab (IFX) (64.5%), followed by etanercept (ETN) (44.2%) and adalimumab (ADA) (36.9%). The incidence of serious infections and tuberculosis (per 100 patient-years) for IFX, ETN and ADA users was 1.99, 0.85 and 0.63; and 1.68, 0.43 and 0.85, respectively. Infusion/injection site reaction was highest with IFX (1.38/100 patient-years). Cox regression revealed increasing age, female sex, not having a diagnosis of spondyloarthritis (SpA) and IFX use were significantly associated with drug withdrawal for either inefficacy or SAEs. Rheumatoid arthritis (RA) had the highest hazard ratio for drug withdrawal but SpA was favorable for drug retention, after adjustment for age, sex, disease duration and the choice of anti-TNFα agents. Conclusions: In our registry, the retention rate of the anti-TNFα agents was lowest but the incidence of tuberculosis, serious infections and infusion reaction was highest with IFX. Older female patients with RA and the use of IFX were independently associated with drug withdrawal.

Original language	English
Pages (from-to)	1-8
Journal	International Journal of Rheumatic Diseases
Volume	17
Issue number	s3
DOIs	https://doi.org/10.1111/1756-185X.12264
Publication status	Published - 1 Dec 2014
Externally published	Yes

Research Keywords

Anti-TNFα
Biologics
Real-life
Registry
Rheumatic diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access Output

10.1111/1756-185X.12264

Other Access Options

Check CityUHK Library

Permanent Link

Right click to copy link

Cite this

Mok, C. C., Chan, K. Y., Lee, K. L., Tam, L. S., Lee, K. W., Tat Chan, E. Y., Chan, K. H., Chan, K. M., Helen Chan, K. Y., Julia Chan, P. S., Chan, Y. K., Lucia Chau, S. Y., Cheung, T. C., Cheung, T., Chung, H. Y., Ho, C., Kun, E., Kwok, L. W., Kwok, M. L., ... Amy Yung, K. M. (2014). Factors associated with withdrawal of the anti-TNFα biologics in the treatment of rheumatic diseases: Data from the Hong Kong Biologics Registry. International Journal of Rheumatic Diseases, 17(s3), 1-8. https://doi.org/10.1111/1756-185X.12264

@article{b8eb28b510424d0094c355ea6f8f9498,

title = "Factors associated with withdrawal of the anti-TNFα biologics in the treatment of rheumatic diseases: Data from the Hong Kong Biologics Registry",

abstract = "Objectives: To study the factors associated with withdrawal of the and tumor necrosis factor alpha (anti-TNFα) biologics in the treatment of rheumatic diseases. Method: Data from the Hong Kong Biologics Registry were retrieved. The cumulative rates of withdrawal of different biological agents were studied by Kaplan-Meier plot and the incidence of serious adverse events (SAEs) was calculated. Factors associated with the withdrawal of the anti-TNFα agents were studied by Cox regression. Results: Between 2005 and 2013, 2059 courses of biologics were used in 1345 patients. After 3454 patient-years, 1171 (57%) courses were terminated because of clinical inefficacy (38.1%), SAEs (22.3%) and financial reasons (15.9%). The most frequent SAEs (per 100-patient-years) were allergy (2.90), serious infections (1.34), tuberculosis (0.93) and infusion/injection site reaction (0.75). Among the anti-TNFα agents, the cumulative probability of drug withdrawal for either inefficacy or SAEs in 5 years was highest with infliximab (IFX) (64.5%), followed by etanercept (ETN) (44.2%) and adalimumab (ADA) (36.9%). The incidence of serious infections and tuberculosis (per 100 patient-years) for IFX, ETN and ADA users was 1.99, 0.85 and 0.63; and 1.68, 0.43 and 0.85, respectively. Infusion/injection site reaction was highest with IFX (1.38/100 patient-years). Cox regression revealed increasing age, female sex, not having a diagnosis of spondyloarthritis (SpA) and IFX use were significantly associated with drug withdrawal for either inefficacy or SAEs. Rheumatoid arthritis (RA) had the highest hazard ratio for drug withdrawal but SpA was favorable for drug retention, after adjustment for age, sex, disease duration and the choice of anti-TNFα agents. Conclusions: In our registry, the retention rate of the anti-TNFα agents was lowest but the incidence of tuberculosis, serious infections and infusion reaction was highest with IFX. Older female patients with RA and the use of IFX were independently associated with drug withdrawal.",

keywords = "Anti-TNFα, Biologics, Real-life, Registry, Rheumatic diseases",

author = "Mok, {Chi Chiu} and Chan, {Ka Yan} and Lee, {Ka Lai} and Tam, {Lai Shan} and Lee, {Ka Wing} and {Tat Chan}, {Eric Yuk} and Chan, {Ka Ho} and Chan, {Ka Man} and {Helen Chan}, {Ka Yan} and {Julia Chan}, {Pui Shan} and Chan, {Yee Ki} and {Lucia Chau}, {Shuk Yi} and Cheung, {Tak Cheong} and Tsang Cheung and Chung, {Ho Yin} and Carmen Ho and Emily Kun and Kwok, {Lai Wa} and Kwok, {Man Leung} and Kitty Kwok and Lam, {Chi Kwai} and Lao, {Weng Ng} and Lau, {Chak Sing} and Lau, {Yu Lung} and {Yiu Lee}, {Anthony Kai} and {Fai Lee}, {Tony Kwok} and Lee, {Kwok Kei} and {Jolly Lee}, {Man Yee} and Lee, {Shui Shan} and Lee, {Tsz Leung} and Tsz Yan and Samson Lee and Leung, {Man Chi} and Li, {Wai Ling} and Liu, {Hor Ming} and Luk, {Ming Chi} and Ma, {Kai Yiu} and Mak, {Lai Wo} and Mok, {Mo Yin} and {Daniel Ng}, {Kam Hung} and Ng, {Woon Leung} and Ho So and Sung, {Chi Keung} and Tan, {Ronald F.} and {Sandy Tang}, {Shuk Kuen} and Wan, {Man Choi} and Wong, {Ching Han} and Wong, {Kong Chiu} and Shiu Man and Wong, {Pui Yan} and Jude Wong and {Raymond Wong}, {Woon Sing} and {Sandy Woo}, {Wai Shan} and Young, {Kit Yu} and Yim, {Cheuk Wan} and {Carrel Yu}, {Ka Lung} and {Catherine Yuen}, {Ka Yan} and {Amy Yung}, {Ka Man}",

year = "2014",

month = dec,

day = "1",

doi = "10.1111/1756-185X.12264",

language = "English",

volume = "17",

pages = "1--8",

journal = "International Journal of Rheumatic Diseases",

issn = "1756-1841",

publisher = "John Wiley & Sons",

number = "s3",

}

Mok, CC, Chan, KY, Lee, KL, Tam, LS, Lee, KW, Tat Chan, EY, Chan, KH, Chan, KM, Helen Chan, KY, Julia Chan, PS, Chan, YK, Lucia Chau, SY, Cheung, TC, Cheung, T, Chung, HY, Ho, C, Kun, E, Kwok, LW, Kwok, ML, Kwok, K, Lam, CK, Lao, WN, Lau, CS, Lau, YL, Yiu Lee, AK, Fai Lee, TK, Lee, KK, Jolly Lee, MY, Lee, SS, Lee, TL, Yan, T, Lee, S, Leung, MC, Li, WL, Liu, HM, Luk, MC, Ma, KY, Mak, LW, Mok, MY, Daniel Ng, KH, Ng, WL, So, H, Sung, CK, Tan, RF, Sandy Tang, SK, Wan, MC, Wong, CH, Wong, KC, Man, S, Wong, PY, Wong, J, Raymond Wong, WS, Sandy Woo, WS, Young, KY, Yim, CW, Carrel Yu, KL, Catherine Yuen, KY & Amy Yung, KM 2014, 'Factors associated with withdrawal of the anti-TNFα biologics in the treatment of rheumatic diseases: Data from the Hong Kong Biologics Registry', International Journal of Rheumatic Diseases, vol. 17, no. s3, pp. 1-8. https://doi.org/10.1111/1756-185X.12264

Factors associated with withdrawal of the anti-TNFα biologics in the treatment of rheumatic diseases: Data from the Hong Kong Biologics Registry. / Mok, Chi Chiu; Chan, Ka Yan; Lee, Ka Lai et al.
In: International Journal of Rheumatic Diseases, Vol. 17, No. s3, 01.12.2014, p. 1-8.

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

TY - JOUR

T1 - Factors associated with withdrawal of the anti-TNFα biologics in the treatment of rheumatic diseases

T2 - Data from the Hong Kong Biologics Registry

AU - Mok, Chi Chiu

AU - Chan, Ka Yan

AU - Lee, Ka Lai

AU - Tam, Lai Shan

AU - Lee, Ka Wing

AU - Tat Chan, Eric Yuk

AU - Chan, Ka Ho

AU - Chan, Ka Man

AU - Helen Chan, Ka Yan

AU - Julia Chan, Pui Shan

AU - Chan, Yee Ki

AU - Lucia Chau, Shuk Yi

AU - Cheung, Tak Cheong

AU - Cheung, Tsang

AU - Chung, Ho Yin

AU - Ho, Carmen

AU - Kun, Emily

AU - Kwok, Lai Wa

AU - Kwok, Man Leung

AU - Kwok, Kitty

AU - Lam, Chi Kwai

AU - Lao, Weng Ng

AU - Lau, Chak Sing

AU - Lau, Yu Lung

AU - Yiu Lee, Anthony Kai

AU - Fai Lee, Tony Kwok

AU - Lee, Kwok Kei

AU - Jolly Lee, Man Yee

AU - Lee, Shui Shan

AU - Lee, Tsz Leung

AU - Yan, Tsz

AU - Lee, Samson

AU - Leung, Man Chi

AU - Li, Wai Ling

AU - Liu, Hor Ming

AU - Luk, Ming Chi

AU - Ma, Kai Yiu

AU - Mak, Lai Wo

AU - Mok, Mo Yin

AU - Daniel Ng, Kam Hung

AU - Ng, Woon Leung

AU - So, Ho

AU - Sung, Chi Keung

AU - Tan, Ronald F.

AU - Sandy Tang, Shuk Kuen

AU - Wan, Man Choi

AU - Wong, Ching Han

AU - Wong, Kong Chiu

AU - Man, Shiu

AU - Wong, Pui Yan

AU - Wong, Jude

AU - Raymond Wong, Woon Sing

AU - Sandy Woo, Wai Shan

AU - Young, Kit Yu

AU - Yim, Cheuk Wan

AU - Carrel Yu, Ka Lung

AU - Catherine Yuen, Ka Yan

AU - Amy Yung, Ka Man

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Objectives: To study the factors associated with withdrawal of the and tumor necrosis factor alpha (anti-TNFα) biologics in the treatment of rheumatic diseases. Method: Data from the Hong Kong Biologics Registry were retrieved. The cumulative rates of withdrawal of different biological agents were studied by Kaplan-Meier plot and the incidence of serious adverse events (SAEs) was calculated. Factors associated with the withdrawal of the anti-TNFα agents were studied by Cox regression. Results: Between 2005 and 2013, 2059 courses of biologics were used in 1345 patients. After 3454 patient-years, 1171 (57%) courses were terminated because of clinical inefficacy (38.1%), SAEs (22.3%) and financial reasons (15.9%). The most frequent SAEs (per 100-patient-years) were allergy (2.90), serious infections (1.34), tuberculosis (0.93) and infusion/injection site reaction (0.75). Among the anti-TNFα agents, the cumulative probability of drug withdrawal for either inefficacy or SAEs in 5 years was highest with infliximab (IFX) (64.5%), followed by etanercept (ETN) (44.2%) and adalimumab (ADA) (36.9%). The incidence of serious infections and tuberculosis (per 100 patient-years) for IFX, ETN and ADA users was 1.99, 0.85 and 0.63; and 1.68, 0.43 and 0.85, respectively. Infusion/injection site reaction was highest with IFX (1.38/100 patient-years). Cox regression revealed increasing age, female sex, not having a diagnosis of spondyloarthritis (SpA) and IFX use were significantly associated with drug withdrawal for either inefficacy or SAEs. Rheumatoid arthritis (RA) had the highest hazard ratio for drug withdrawal but SpA was favorable for drug retention, after adjustment for age, sex, disease duration and the choice of anti-TNFα agents. Conclusions: In our registry, the retention rate of the anti-TNFα agents was lowest but the incidence of tuberculosis, serious infections and infusion reaction was highest with IFX. Older female patients with RA and the use of IFX were independently associated with drug withdrawal.

AB - Objectives: To study the factors associated with withdrawal of the and tumor necrosis factor alpha (anti-TNFα) biologics in the treatment of rheumatic diseases. Method: Data from the Hong Kong Biologics Registry were retrieved. The cumulative rates of withdrawal of different biological agents were studied by Kaplan-Meier plot and the incidence of serious adverse events (SAEs) was calculated. Factors associated with the withdrawal of the anti-TNFα agents were studied by Cox regression. Results: Between 2005 and 2013, 2059 courses of biologics were used in 1345 patients. After 3454 patient-years, 1171 (57%) courses were terminated because of clinical inefficacy (38.1%), SAEs (22.3%) and financial reasons (15.9%). The most frequent SAEs (per 100-patient-years) were allergy (2.90), serious infections (1.34), tuberculosis (0.93) and infusion/injection site reaction (0.75). Among the anti-TNFα agents, the cumulative probability of drug withdrawal for either inefficacy or SAEs in 5 years was highest with infliximab (IFX) (64.5%), followed by etanercept (ETN) (44.2%) and adalimumab (ADA) (36.9%). The incidence of serious infections and tuberculosis (per 100 patient-years) for IFX, ETN and ADA users was 1.99, 0.85 and 0.63; and 1.68, 0.43 and 0.85, respectively. Infusion/injection site reaction was highest with IFX (1.38/100 patient-years). Cox regression revealed increasing age, female sex, not having a diagnosis of spondyloarthritis (SpA) and IFX use were significantly associated with drug withdrawal for either inefficacy or SAEs. Rheumatoid arthritis (RA) had the highest hazard ratio for drug withdrawal but SpA was favorable for drug retention, after adjustment for age, sex, disease duration and the choice of anti-TNFα agents. Conclusions: In our registry, the retention rate of the anti-TNFα agents was lowest but the incidence of tuberculosis, serious infections and infusion reaction was highest with IFX. Older female patients with RA and the use of IFX were independently associated with drug withdrawal.

KW - Anti-TNFα

KW - Biologics

KW - Real-life

KW - Registry

KW - Rheumatic diseases

UR - http://www.scopus.com/inward/record.url?scp=84921292134&partnerID=8YFLogxK

UR - https://www.scopus.com/record/pubmetrics.uri?eid=2-s2.0-84921292134&origin=recordpage

U2 - 10.1111/1756-185X.12264

DO - 10.1111/1756-185X.12264

M3 - RGC 21 - Publication in refereed journal

C2 - 24382315

SN - 1756-1841

VL - 17

SP - 1

EP - 8

JO - International Journal of Rheumatic Diseases

JF - International Journal of Rheumatic Diseases

IS - s3

ER -

Factors associated with withdrawal of the anti-TNFα biologics in the treatment of rheumatic diseases: Data from the Hong Kong Biologics Registry

Abstract

Research Keywords

UN SDGs

Access Output

Other Access Options

Permanent Link

Other Files and Links

Fingerprint

Cite this