Table 3.

Predictors of first TNFi discontinuation over a maximum of 5 years of follow-up in 9139 Swedish patients with rheumatoid arthritis*

	Unadjusted HR (95% CI)	p Value	Adjusted HR (95% CI)	p Value
Age (per 10 years)	1.06 (1.03 to 1.08)	<0.001	1.02 (0.99 to 1.05)	0.13
Women	1.16 (1.07 to 1.25)	<0.001	1.12 (1.04 to 1.21)	0.004
Men	1.00 (ref)		1.00 (ref)
Education level
<9 years	1.20 (1.10 to 1.32)	<0.001	1.14 (1.04 to 1.25)	<0.001
10–12 years	1.22 (1.12 to 1.32)	<0.001	1.20 (1.10 to 1.30)
>12 years	1.00 (ref)		1.00 (ref)
Missing	1.15 (0.91 to 1.46)	0.23	1.06 (0.83 to 1.34)
Period
2003–2005	1.00 (ref)	0.15	1.00 (ref)	<0.001
2006–2009	1.06 (0.99 to 1.14)		1.13 (1.06 to 1.21)
2010–2011	1.09 (0.98 to 1.21)		1.20 (1.10 to 1.30)
HAQ at baseline		<0.001		<0.001
<1	1.00 (ref)		1.00 (ref)
1–1.49	1.21 (1.11 to 1.32)		1.19 (1.09 to 1.30)
1.5–1.9	1.29 (1.18 to 1.42)		1.22 (1.11 to 1.34)
≥2	1.42 (1.28 to 1.57)		1.26 (1.13 to 1.41)
Missing	1.09 (0.97 to 1.22)		0.97 (0.86 to 1.09)
Concomitant drug use
Non-biological DMARDs	0.78 (0.72 to 0.84)	<0.001	0.78 (0.72 to 0.84)	<0.001
No non-biological DMARDs	1.00 (ref)		1.00 (ref)
General patient frailty†
Hospital days (per 10)	1.07 (1.04 to 1.09)	<0.001	1.04 (1.01 to 1.06)	0.002
Outpatient visits (per 10)	1.14 (1.10 to 1.18)	<0.001	1.13 (1.09 to 1.17)	<0.001

*Cox regression models performed by strata defined by biological drug; HRs >1 indicate more likely to discontinue first TNFi.

†Assessed during the 2 years preceding TNFi initiation. Data on hospital days and non-primary outpatient care visits retrieved from the Swedish National Patient Register between 2001 and 2009.

DMARD, disease modifying antirheumatic drug; HAQ, health assessment questionnaire; TNFi, tumour necrosis factor inhibitor.