Persistencia de medicamentos biológicos durante ocho años en pacientes con artritis reumatoide y espondiloartritis

María Ángeles González-Fernández; Elena Villamañán; Inmaculada Jiménez-Nácher; Francisco Moreno; Alicia Herrero; Alejandro Balsa

doi:10.7399/fh.11080

Persistencia de medicamentos biológicos durante ocho años en pacientes con artritis reumatoide y espondiloartritis

María Ángeles González-Fernández, Elena Villamañán, Inmaculada Jiménez-Nácher, Francisco Moreno, Alicia Herrero, Alejandro Balsa

Resumen

Objetivo: Calcular y analizar la persistencia global y por medicamento, en primera y segunda línea de tratamiento, en pacientes con artritis reumatoide, espondiloartritis axial radiográfica y no radiográfica y artritis psoriásica durante un periodo de ocho años.

Método: Estudio retrospectivo observacional de persistencia en pacientes que iniciaron su terapia con medicamentos biológicos entre enero de 2009 y diciembre de 2012 en seguimiento hasta diciembre de 2016.

Resultados: Se analizaron 132, 87 y 33 pacientes con artritis reumatoide, espondiloartritis y artritis psoriásica, respectivamente. La persistencia mediana global para los biológicos en primera y segunda línea fueron: 30,9 meses y 14 meses, respectivamente, en artritis reumatoide; 63,06 meses y 25,6 meses en espondiloartritis. No se alcanzó la persistencia mediana en los ocho años de seguimiento en artritis psoriásica (> 70 meses) (p = 0,002 para la función de supervivencia entre patologías en primera línea). Persistencia mediana alcanzada en primera línea por medicamento: tocilizumab (58,3 meses), seguido de etanercept (44 meses) en artritis reumatoide (p = 0,79); en espondiloartritis golimumab y etanercept fueron los más persistentes (no alcanzaron la mediana), seguidos de
adalimumab (44 meses) e infliximab (50,1 meses). En artritis psoriásica, golimumab seguido de infliximab y etanercept fueron los más persistentes (no alcanzaron la mediana), y adalimumab (59,4 meses). Persistencia mediana alcanzada en segunda línea por medicamento: tocilizumab (22,1 meses) en artritis reumatoide. Golimumab fue el más persistente en espondiloartritis y artritis psoriásica (sin alcanzar la mediana).

Conclusiones: Tocilizumab y etanercept fueron los medicamentos más persistentes en artritis reumatoide, y golimumab en espondiloartritis y artritis psoriásica en primera y segunda línea de tratamiento.

Palabras clave

Persistencia; Artritis reumatoide; Espondiloartropatías; Agentes antirreumáticos; Terapia biológica

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DOI: http://dx.doi.org/10.7399%2Ffh.11080