Session Type: Abstract Submissions (ACR)
Background/Purpose: Adalimumab (ADA) and etanercept (ETN) are two commonly used tumor necrosis factor (TNF)-α antagonists for the treatment of rheumatoid arthritis (RA). The study is aimed to compare the rate of experiencing RA-related urgent care and surgery, and the risk of developing new comorbidities between ADA- and ETN-treated patients with RA.
Methods: Adult RA (ICD-9-CM: 714) patients who initiated ADA or ETN were identified from the Thomson MarketScan database (2005-2009). The date of the first prescription of ADA or ETN was defined as the index date. Patients were required to have continuous eligibility for at least 6 months prior to (baseline period) and 12 months after (study period) the index date. In addition, patients were required to be free of other medical conditions (e.g., Crohn’s disease and psoriasis), for which ADA or ETN is indicated, during the baseline period. Baseline characteristics (demographics, comorbidities, prior treatments for RA and health care resource use) were compared between the ADA and ETN cohorts using Chi-square tests for categorical variables or Wilcoxon rank-sum tests for continuous variables. The rate of experiencing RA-related urgent care (i.e., inpatient or emergency room visits associated with RA diagnoses), RA-related surgery, and the risk of developing new comorbidities (including gastrointestinal disease, cardiovascular disease, diabetes, hypertension, osteoporosis) during the study period were compared between the two cohorts using Cox proportional hazards models, adjusting for the above baseline characteristics.
Results: A total of 3,109 ADA-treated RA patients and 3,972 ETN-treated RA patients met the study inclusion and exclusion criteria. Compared to ETN-treated patients, ADA-treated patients were older (50.2 vs. 49.4, p=0.006), and had a higher baseline use of methotrexate (62.9% vs. 58.7%, p<0.001). After adjusting for baseline characteristics, ADA was associated with a significant lower rate of experiencing RA-related urgent care (hazard ratio [HR]=0.82, 95% confidence interval [CI]=0.67-0.99) and RA-related surgery (HR=0.65; 95% CI=0.47-0.91). ADA was also associated with a lower risk of developing new gastrointestinal disease compared to ETN (HR =0.85; 95% CI: 0.76-0.95). The risks of developing other comorbidities including cardiovascular diseases, diabetes, hypertension, and osteoporosis were not significantly different between the two cohorts.
Conclusion: Compared to those treated with ETN, patients with RA treated with ADA, were less likely to experience an RA-related urgent care or RA-related surgery, and to develop new gastrointestinal disease.
E. Q. Wu,
« Back to 2012 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparison-of-rheumatoid-arthritis-related-health-care-resource-use-and-comorbidities-among-patients-with-rheumatoid-arthritis-treated-with-adalimumab-vs-etanercept/