ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 2954

Factors Related to Initiation of TNF Inhibitor Versus Triple Therapy in Rheumatoid Arthritis Patients

Yinzhu Jin1, Eun Ha Kang2, Angela Tong1, Rishi J. Desai3 and Seoyoung C. Kim4,5, 1Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 2Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea, Republic of (South), 3Division of Pharmacoepidemiology and Pharmacoeconimics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 4Division of Pharmacoepidemiology and Pharmocoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 5Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: methotrexate (MTX), population studies, rheumatoid arthritis (RA) and tumor suppressors

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Wednesday, October 24, 2018

Title: 6W018 ACR Abstract: Epidemiology & Pub Health IV: Determinants & Consequences of Tx (2952–2957)

Session Type: ACR Concurrent Abstract Session

Session Time: 11:00AM-12:30PM

Background/Purpose: While efficacy of triple therapy [methotrexate (MTX), sulfasalazine (HCQ), and sulfasalazine (SSZ)] and TNF inhibitor (TNFi) plus MTX was similar in a previous clinical trial, use of triple therapy is infrequent in the US.  We aimed to examine geographical and clinical factors associated with the two treatment strategies for RA.

Methods: We used Truven MarketScan data (2003-2014) to conduct a cohort study among RA patients ≥18 years old with MTX prescription.  Triple therapy was defined as adding on both HCQ and SSZ, and TNFi therapy was defined as adding a TNFi to MTX. Index date was the first dispensing date of the last drug to complete triple therapy, or TNFi.  Exclusion criteria included malignancy, renal dialysis, HIV, nursing home stay, or hospitalized infection, and any prior use of study drugs except MTX 180 days before the index date. We assessed geographic patterns and baseline covariates including demographics, comorbidities, medications, and health care utilizations associated with starting TNFi or triple therapy using multivariable logistic regression.

Results: We identified a total of 46,693 patients (45,305 (97.0%) TNFi plus MTX and 1,388 (3.0%) triple therapy initiators). Females were more likely to receive TNFi therapy (OR, 95% CI =1.17, 1.04-1.33, Table). We noted a significant geographical pattern with regard to initiation of triple therapy (Figure). Patients were most likely to receive triple therapy in Midwest (Table, Figure). Specifically, Nebraska had the highest rate of receiving triple therapy, followed by its adjacent states. We did not find any association between underlying cardiovascular diseases and either of two treatment groups. However, obese patients were 42% more likely to be started on triple therapy. Baseline psoriasis and inflammatory bowel disease increased odds of receiving TNFi (OR, 95% CI = 4.88, 3.05-7.80 and 3.57, 1.14-11.14). Generally, TNFi initiators used more medications and had rheumatologist or inpatient visit more frequently than those on triple therapy.

Conclusion: In this large nationwide cohort of RA patients, triple therapy use was infrequent.  Geographical and certain clinical factors such as coexisting psoriasis or inflammatory bowel disease, use of bisphosphonates, proton pump inhibitors, frequency of rheumatologists visit, and inpatient visit were associated with choosing TNFi versus triple therapy.


 


Disclosure: Y. Jin, None; E. H. Kang, None; A. Tong, None; R. J. Desai, None; S. C. Kim, Roche, Pfizer, and Bristol-Myers Squibb, 2.

To cite this abstract in AMA style:

Jin Y, Kang EH, Tong A, Desai RJ, Kim SC. Factors Related to Initiation of TNF Inhibitor Versus Triple Therapy in Rheumatoid Arthritis Patients [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/factors-related-to-initiation-of-tnf-inhibitor-versus-triple-therapy-in-rheumatoid-arthritis-patients/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/factors-related-to-initiation-of-tnf-inhibitor-versus-triple-therapy-in-rheumatoid-arthritis-patients/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology