Table 2.
Crude TNFi retention and adjusted HR for TNFi discontinuation (upper part of table), and crude proportion achieving remission and adjusted OR for clinical remission (lower part of table) for infliximab, adalimumab and etanercept, in co-medication with methotrexate compared with monotherapy
| Infliximab | Adalimumab | Etanercept | ||
| One-year TNFi retention (%) and adjusted* HR for TNFi discontinuation (ref=monotherapy) | ||||
| Czech republic | co-med/mono | NA | 92%/79% | 89%/89% |
| HR (95% CI) | NA | 0.36 (0.17 to 0.77) | 1.06 (0.31 to 3.63) | |
| Finland | co-med/mono | NA | 87%/90% | 95%/96% |
| HR (95% CI) | NA | 1.18 (0.41 to 3.35) | 2.08 (0.31 to 13.94) | |
| Italy | co-med/mono | 80%/87% | 82%/88% | 85%/89% |
| HR (95% CI) | 1.45 (0.63 to 3.35) | 1.63 (0.98 to 2.72) | 1.45 (0.84 to 2.51) | |
| Portugal | co-med/mono | NA | 89%/97% | 89%/84% |
| HR (95% CI) | NA | 7.39 (1.46 to 37.54) | 0.60 (0.28 to 1.30) | |
| Spain | co-med/mono | NA | 82%/82% | 77%/78% |
| HR (95% CI) | NA | 0.70 (0.26 to 1.90) | 0.76 (0.30 to 1.90) | |
| Slovenia | co-med/mono | NA | 80%/67% | NA |
| HR (95% CI) | NA | 0.90 (0.41 to 1.96) | NA | |
| Iceland | co-med/mono | 81%/78% | NA | NA |
| HR (95% CI) | 0.81 (0.39 to 1.70) | NA | NA | |
| Switzerland | co-med/mono | 77%/73% | 79%/72% | 80%/78% |
| HR (95% CI) | 0.78 (0.39 to 1.58) | 0.67 (0.45 to 1.00) | 0.81 (0.49 to 1.35) | |
| Sweden | co-med/mono | 71%/63% | 78%/66% | 76%/74% |
| HR (95% CI) | 0.65 (0.50 to 0.85) | 0.58 (0.47 to 0.72) | 0.94 (0.77 to 1.14) | |
| Norway | co-med/mono | NA | 83%/68% | 81%/70% |
| HR (95% CI) | NA | 0.59 (0.24 to 1.48) | 0.59 (0.35 to 1.01) | |
| Denmark | co-med/mono | 64%/45% | 71%/70% | 70%/72% |
| HR (95% CI) | 0.56 (0.41 to 0.78) | 0.93 (0.70 to 1.24) | 1.12 (0.77 to 1.62) | |
| Crude proportion (%) reaching remission at 12 months and adjusted* OR for clinical remission (ref=monotherapy) | ||||
| Pooled | co-med/mono | 38%/32% | 47%/38% | 44%/42% |
| OR (95% CI) | 1.55 (1.21 to 1.98) | 1.45 (1.23 to 1.72) | 1.12 (0.95 to 1.31) | |
| Czech republic | co-med/mono | NA | 57%/38% | 68%/57% |
| OR (95% CI) | NA | 2.25 (1.23 to 4.20) | 1.69 (0.66 to 4.33) | |
| Finland | co-med/mono | NA | NA | NA |
| OR (95% CI) | NA | NA | NA | |
| Italy | co-med/mono | 29%/42% | 43%/45% | 46%/47% |
| OR (95% CI) | 0.59 (0.12 to 2.58) | 1.07 (0.55 to 2.07) | 1.09 (0.59 to 2.02) | |
| Portugal | co-med/mono | NA | 54%/49% | 51%/54% |
| OR (95% CI) | NA | 1.26 (0.49 to 3.27) | 1.40 (0.64 to 3.15) | |
| Spain | co-med/mono | NA | NA | NA |
| OR (95% CI) | NA | NA | NA | |
| Slovenia | co-med/mono | NA | 42%/47% | NA |
| OR (95% CI) | NA | 0.69 (0.28 to 1.68) | NA | |
| Iceland | co-med/mono | NA* | NA | NA |
| OR (95% CI) | NA* | NA | NA | |
| Switzerland | co-med/mono | NA | 40%/33% | 37%/21% |
| OR (95% CI) | NA | 1.68 (0.94 to 3.06) | 2.94 (1.28 to 7.18) | |
| Sweden | co-med/mono | 37%/27% | 43%/33% | 41%/38% |
| OR (95% CI) | 1.73 (1.17 to 2.60) | 1.59 (1.2 to 2.11) | 1.03 (0.82 to 1.31) | |
| Norway | co-med/mono | NA | 54%/47% | 49%/50% |
| OR (95% CI) | NA | 1.58 (0.54 to 4.66) | 0.95 (0.52 to 1.74) | |
| Denmark | co-med/mono | 34%/21% | 45%/37% | 42%/37% |
| OR (95% CI) | 2.01 (1.13 to 3.72) | 1.42 (0.99 to 2.03) | 1.15 (0.72 to 1.85) | |
HR and OR are adjusted for age, sex, calendar year, disease duration and DAS28-CRP.
co-med/mono indicates the crude 1 year TNFi retention rate and the proportion in the co-medication/monotherapy groups reaching remission, respectively.
*NA=not available due to <30 patients in at least one of the exposure groups. Data from Romania and Turkey are not included in the table because they provided no strata in the analysis with ≥30 patients in both groups. Adjusted for baseline age, sex, calendar year, DAS28-CRP and disease duration.
CRP, C reactive protein; DAS28, Disease Activity Score with 28 joints; TNFi, tumour necrosis factor inhibitors.