TABLE 2.
Treatment Patterns Measured During the 12 Months of Follow-up
| ADA n = 2,481 | CERT n = 71 | ETA n = 1,200 | GOL-IV n = 54 | GOL-SC n = 59 | INF n = 203 | SEC n = 367 | UST n = 362 | APR n = 1,705 | TOF n = 37 | |
|---|---|---|---|---|---|---|---|---|---|---|
| Persistent on index drug, < 60-day gap, n (%) | 1,195 (48.2) | 65 (38.0) | 526 (44.0) | 27 (50.0) | 35 (59.3) | 115 (56.7) | 206 (56.1) | 114 (31.5) | 759 (45.5) | 20 (54.1) |
| Days persistent on index drug, mean (SD) | 250 (125) | 214 (132) | 235 (130) | 271 (115) | 276 (117) | 266 (128) | 266 (125) | 202 (132) | 232 (135) | 253 (134) |
| Persistent on index drug-sensitivity, < 45-day gap, n (%) | 1,086 (43.8) | 55 (32.2) | 468 (39.0) | 24 (44.4) | 29 (49.2) | 108 (53.2) | 188 (51.2) | 81 (22.4) | 690 (40.5) | 19 (51.4) |
| Persistent on index drug-sensitivity, < 90-day gap, n (%) | 1,337 (53.9) | 76 (44.4) | 609 (50.8) | 30 (55.6) | 36 (61.0) | 131 (64.5) | 229 (62.4) | 192 (53.0) | 872 (51.1) | 21 (56.8) |
| Discontinue, ≥ 90-day gap, n (%) | 1,144 (46.1) | 95 (55.6) | 591 (49.3) | 24 (44.4) | 23 (39.0) | 72 (35.5) | 138 (37.6) | 170 (47.0) | 833 (48.9) | 16 (43.2) |
| Days to discontinuation among those who discontinue, mean (SD) | 133 (72) | 110 (65) | 122 (70) | 148 (93) | 139 (65) | 120 (77) | 127 (75) | 119.0 (79) | 112 (74) | 123.0 (82) |
| Switching to another biologic or tsDMARD, n | 519 | 49 | 285 | 9 | 13 | 32 | 52 | 48 | 290 | 7 |
| % of all patients | 20.9 | 28.7 | 23.8 | 16.7 | 22.0 | 15.8 | 14.2 | 13.3 | 17.0 | 18.9 |
| Most common drug switched to among those who switch (%) | ETA (33.7) | SEC (20.4) | ADA (53.7) | ABAT-IV (33.3) | SEC (23.1) | APR (31.3) | IXE (26.9) | SEC (43.8) | ADA (36.2) | ETA, ADA (28.6) |
| % of discontinuers | 45.4 | 51.6 | 48.2 | 37.5 | 56.5 | 44.4 | 37.7 | 28.2 | 34.8 | 43.8 |
| Reinitiation of index therapy, n | 127 | 9 | 86 | 4 | 2 | 9 | 21 | 55 | 117 | 2 |
| % of all patients | 5.1 | 5.3 | 7.2 | 7.4 | 3.4 | 4.4 | 5.7 | 15.2 | 6.9 | 5.4 |
| % of discontinuers | 11.1 | 9.5 | 14.6 | 16.7 | 8.7 | 12.5 | 15.2 | 32.4 | 14.0 | 12.5 |
| PDC of index drug over 12-month follow-up, mean (SD) | 0.61 (0.29) | 0.51 (0.30) | 0.58 (0.30) | 0.69 (0.31) | 0.66 (0.27) | 0.68 (0.31) | 0.64 (0.29) | 0.53 (0.27) | 0.56 (0.31) | 0.63 (0.31) |
| Highly adherent, PDC ≥ 0.80, n (%) | 975 (39.3) | 42 (24.6) | 408 (34.0) | 26 (48.2) | 25 (42.4) | 96 (47.3) | 164 (44.7) | 76 (21.0) | 570 (33.4) | 17 (46.0) |
| PDC of index drug before discontinuation, mean (SD) | 0.88 (0.12) | 0.86 (0.14) | 0.87 (0.13) | 0.93 (0.12) | 0.89 (0.10) | 0.90 (0.13) | 0.85 (0.12) | 0.80 (0.20) | 0.87 (0.13) | 0.88 (0.10) |
| MPR of index drug over 12-month follow-up, mean (SD) | 0.63 (0.30) | 0.52 (0.30) | 0.59 (0.31) | 0.69 (0.31) | 0.69 (0.28) | 0.69 (0.31) | 0.66 (0.30) | 0.55 (0.28) | 0.58 (0.32) | 0.65 (0.32) |
| Highly adherent, MPR ≥ 0.80, n (%) | 1,051 (42.4) | 43 (25.2) | 449 (37.4) | 26 (48.2) | 29 (49.2) | 96 (47.3) | 181 (49.3) | 85 (23.5) | 648 (38.0) | 19 (51.4) |
| MPR of index drug before discontinuation, mean (SD) | 0.90 (0.12) | 0.87 (0.13) | 0.89 (0.13) | 0.93 (0.12) | 0.91 (0.09) | 0.90 (0.13) | 0.87 (0.13) | 0.80 (0.20) | 0.88 (0.13) | 0.90 (0.10) |
| Concomitant medication use, n (%) | ||||||||||
| Corticosteroids (oral or injectable) | 1,197 (48.3) | 101 (59.1) | 612 (51.0) | 34 (63.0) | 40 (67.8) | 138 (68.0) | 206 (56.1) | 177 (48.9) | 841 (49.3) | 23 (62.2) |
| Methotrexate | 726 (29.3) | 53 (31.0) | 301 (25.1) | 23 (42.6) | 22 (37.3) | 84 (41.4) | 89 (24.3) | 62 (17.1) | 267 (15.7) | 13 (35.1) |
| Leflunomide | 77 (3.1) | 12 (7.0) | 48 (4.0) | 5 (9.3) | 5 (8.5) | 10 (4.9) | 15 (4.1) | 13 (3.6) | 50 (2.9) | 3 (8.1) |
| Sulfasalazine | 125 (5.0) | 11 (6.4) | 72 (6.0) | 4 (7.4) | 6 (10.2) | 15 (7.4) | 22 (6.0) | 14 (3.9) | 79 (4.6) | 2 (5.4) |
| Cyclosporine | 10 (0.4) | 2 (1.2) | 4 (0.3) | 0 (0.0) | 0 (0.0) | 2 (1.0) | 2 (0.5) | 5 (1.4) | 3 (0.2) | 0 (0.0) |
| Azathioprine | 8 (0.3) | 1 (0.6) | 5 (0.4) | 0 (0.0) | 1 (1.7) | 3 (1.5) | 1 (0.3) | 3 (0.8) | 5 (0.3) | 0 (0.0) |
ADA = adalimumab; APR = apremilast; CERT = certolizumab; ETA = etanercept; GOL-IV = golimumab intravenous; GOL-SC = golimumab subcutaneous; INF = infliximab; IXE = ixekizumab; MPR = medication possession ratio; PDC = proportion of days covered; SEC = secukinumab; tsDMARDs = targeted synthetic disease-modifying antirheumatic drugs; TOF = tofacitinib; UST = ustekinumab.