scholarly journals POS0648 SURVIVAL ANALYSIS OF TIME TO FIRST ADVERSE DRUG REACTION AND DRUG SURVIVAL IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH METHOTREXATE AND HYDROXYCHLOROQUINE MONOTHERAPIES OR COMBINATION THERAPY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 562-563
Author(s):  
K. Velthuis ◽  
M. Nguyen ◽  
J. Scholl ◽  
J. Jansen ◽  
J. Van Lint ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Survival Analysis ◽  
Drug Use ◽  
Combination Therapy ◽  
Drug Discontinuation ◽  
Exact Test ◽  
Drug Survival ◽  
Kaplan Meier ◽  
First Time ◽  
Start Dates

Background:Methotrexate (MTX) and hydroxychloroquine (HCQ) are first line treatments of rheumatoid arthritis (RA). Adverse drug reactions (ADRs) during treatment with these drugs are common. Survival analysis on time to first ADR and on first time drug use duration have not yet been performed for these drugs in real-world settings.Objectives:To compare proportions of patients with ADRs during first time use of either MTX monotherapy, HCQ monotherapy or MTX+HCQ combination therapy and to compare survival to first ADR and drug survival between these drugs.Methods:Retrospective single centre cohort study including adult RA patients treated with either MTX monotherapy, HCQ monotherapy or MTX+HCQ combination therapy. First time users between 1 January 2003 and 30 April 2020 were followed until discontinuation of their first time drug use. The proportion of patients with ADRs was defined as the percentage of patients experiencing an ADR during their first time drug use. Survival to first ADR and drug survival of first time drug use were also assessed. MTX+HCQ use was considered combination therapy when the start dates of these drugs differed less than 14 days. For both monotherapies, end of first time drug use was defined as drug discontinuation for more than 90 days. For MTX+HCQ combination therapy, end of first time drug use was defined as discontinuation of either MTX, HCQ or both for more than 90 days. Differences in the proportion of patients experiencing an ADR during first time drug use of MTX, HCQ or a combination of both was statistically tested using Fisher’s Exact Test. Survival to first ADR and drug survival were studied by Kaplan-Meier analysis and statistically tested by performing Log Rank tests.Results:In total, 794 patients were included (MTX 363, HCQ 77, MTX+HCQ 354). For 156 patients (19.6%) at least one ADR was registered during first time drug use (MTX 59 [16.3%], HCQ 9 [11.7%], MTX+HCQ 88 [24.9%]). Proportions of ADRs differed significantly between MTX monotherapy and MTX+HCQ combination therapy (p=0.005) and between HCQ monotherapy and MTX+HCQ combination therapy (p=0.011). Survival to first ADR also differed significantly for both monotherapies compared to MTX+HCQ combination therapy (medians not reached, p<0.001 and p<0.008, respectively (figure 1A)). Drug survival differed significantly between MTX and HCQ monotherapy and between MTX monotherapy and MTX+HCQ combination therapy (median survival MTX 3.32 years (95% CI [2.81-3.83]; HCQ 1.39 years (95% CI [1.03-1.75]); MTX+HCQ 1.23 years (95% CI [1.11-1.34]), both p<0.001 (figure 1B)).Figure 1.Kaplan-Meier curves of MTX and HCQ monotherapies and MTX+HCQ combination therapy, with (a) survival to first ADR and (b) drug survival.Conclusion:Patients using MTX+HCQ combination therapy are more likely to experience an ADR during the first time drug use compared to MTX and HCQ monotherapies. MTX+HCQ combination therapy also leads to experiencing an ADR sooner compared to both monotherapies. Drug survival of patients treated with HCQ monotherapy as well as MTX+HCQ combination therapy is shorter compared to MTX monotherapy.Disclosure of Interests:Kimberly Velthuis: None declared, My Nguyen: None declared, Joep Scholl: None declared, Jurriaan Jansen: None declared, Jette van Lint: None declared, Peter ten Klooster: None declared, Harald Vonkeman Consultant of: BMS, Celgene, Celltrion, Galapagos, Gilead, Janssen-Cilag, Lilly, Novartis, Pfizer, Sanofi-Genzyme, Grant/research support from: Abbvie, Naomi Jessurun: None declared

scholarly journals AB0196 SURVIVAL ANALYSIS OF TIME TO FIRST ADVERSE DRUG REACTION AND DRUG SURVIVAL IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH ADALIMUMAB AND ETANERCEPT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1122.1-1122
Author(s):  
M. Nguyen ◽  
K. Velthuis ◽  
J. Scholl ◽  
J. Jansen ◽  
L. Kosse ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Drug Treatment ◽  
Median Survival ◽  
Exact Test ◽  
Drug Survival ◽  
Time Treatment ◽  
Kaplan Meier ◽  
Ada 95 ◽  
Continuous Use ◽  
First Time

Background:Treatment of rheumatoid arthritis (RA) with biologic disease-modifying antirheumatic drugs (bDMARDs) has been common practice in the last two decades. However, differences in patients experiencing adverse drug reactions (ADRs) between individual bDMARDs, such as adalimumab (ADA) and etanercept (ETN), during first time treatment has not been studied yet in real-world settings.Objectives:To compare proportions of RA patients experiencing ADRs as well as survival to first ADR and drug survival during treatment with ADA and ETN.Methods:Retrospective single centre cohort study including adult patients with RA, treated with either ADA or ETN between 1 January 2003 and 30 April 2020. The proportions of patients experiencing an ADR were compared by assessing the percentage of patients, treated with either ADA or ETN, experiencing at least one ADR during their first time treatment. Survival to first ADR and drug survival were assessed by calculating time between start of treatment and first ADR and start of treatment and discontinuation of treatment respectively. Stop and restart of treatment within 90 days was considered as continuous use. Differences in proportions were statistically tested using Fisher’s Exact Test. Differences in drug survival between ADA and ETN were tested by Kaplan-Meier analysis and Log Rank tests.Results:A total of 422 patients were included in this study (ADA 259, ETN 163). For 93 patients (21.2%) an ADR was registered during first time treatment. The proportion of patients experiencing at least one ADR during their first time treatment was 22.7% for ADA and 20.2% for ETN (p=0.628). Survival time to first ADR did not differ significantly between ADA and ETN (median survival ADA 10.34 years (95% CI [7.62-13.06], median survival ETN not reached, p=0.109, figure 1A). Median drug survival was 1.75 years for ADA (95 CI [1.38-2.11]) and 2.68 years for ETN (95% CI [1.73-3.64]). Drug survival differed significantly (p<0.001, figure 1B).Figure 1.Kaplan-Meier survival curves for adalimumab and etanercept with (a) survival to first ADR and (b) drug survival.Conclusion:Neither the proportion of patients experiencing ADRs nor survival to first ADR during first time treatment with ADA and ETN differed significantly. Drug survival of first time drug treatment of ADA was significantly lower compared to drug survival of first time drug treatment of ETN.Disclosure of Interests:My Nguyen: None declared, Kimberly Velthuis: None declared, Joep Scholl: None declared, Jurriaan Jansen: None declared, Leanne Kosse: None declared, Peter ten Klooster: None declared, Naomi Jessurun: None declared, Harald Vonkeman Consultant of: BMS, Celgene, Celltrion, Galapagos, Gilead, Janssen-Cilag, Lilly, Novartis, Pfizer, Sanofi-Genzyme, Grant/research support from: Abbvie

Reasons for Discontinuation and Adverse Effects of TNFα Inhibitors in a Cohort of Patients With Rheumatoid Arthritis and Ankylosing Spondylitis

2016 ◽  
Vol 51 (5) ◽  
pp. 388-393 ◽  
Author(s):  
María Henar García-Lagunar ◽  
María Rocío Gutiérrez-Cívicos ◽  
María Sergia García-Simón ◽  
Pablo Conesa-Zamora ◽  
Enrique Jimenez-Santos ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Adverse Effects ◽  
Dosage Regimen ◽  
Survival Rates ◽  
Drug Survival ◽  
Kaplan Meier ◽  
Tnfα Inhibitors ◽  
Treatment Objective ◽  
Factor Α

Background: The introduction of anti–tumor necrosis factor α (anti-TNFα) drugs has improved the clinical outcomes in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). However, these drugs may cause adverse effects that motivate a change in or discontinuation of the treatment. Objective: To evaluate the causes of discontinuation or changes in the dosage regimen in a cohort of patients with RA and AS treated with infliximab, adalimumab, etanercept, and golimumab under clinical practice conditions. Methods: This was a retrospective observational study that included patients with RA or AS treated with anti-TNFα drugs between 2008 and 2013. Changes in the dosage regimen, reasons for treatment discontinuation, and adverse effects were recorded and analyzed. Time to discontinuation was estimated using Kaplan-Meier survival analysis. Results: A total of 123 patients with RA and 93 patients with AS were treated with anti-TNFα therapy. During the study, 55.3% of RA patients and 41.7% of AS patients had stopped the treatment. The most frequent changes were modifications in the dosing, and the most frequent adverse effects were reactions after the infusion or injection (53.8% and 66.7% in RA and AS, respectively). Drug survival of etanercept in RA (67.9%) is greater than for adalimumab and infliximab, whereas drug survival of infliximab in AS (70.0%) is greater than for etanercept and adalimumab at 5 years, although there were no significant differences ( P = 0.098 in RA and 0.194 in AS). Conclusions: The main cause of discontinuation of anti-TNFα is therapeutic failure in both diseases. Etanercept and infliximab have the best survival rates in RA and AS, respectively.

Tolerance, survival and adherence to treatment with methotrexate in patients with rheumatoid arthritis

2019 ◽  
pp. 13-17
Author(s):  
J.M. Sevillano Gutierrez ◽  
D. Capelusnik ◽  
E.E. Schneeberger ◽  
G. Citera
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Events ◽  
Descriptive Statistics ◽  
P Value ◽  
Multiple Logistic Regression ◽  
Adherence To Treatment ◽  
Exact Test ◽  
Cumulative Survival ◽  
Kaplan Meier ◽  
Chi2 Test

Background: Methotrexate (MTX) is the most frequently used medication in patients with Rheumatoid Arthritis (RA). However, several authors have questioned its success due to the presence of adverse events and the lack of adherence. Objectives: to determine cumulative survival of MTX, frequency and type of adverse events and causes of discontinuation in patients with RA. Methods: consecutive patients 18 years and older with a diagnosis of RA (ACR/EULAR 2010 criteria), who had begun treatment with MTX during their disease were included. Sociodemographic, clinical and therapeutic data were collected. Date of initiation and suspension of MTX, route of administration, concomitant treatments, consumption of coffee and tobacco, presence of adverse events (AE) were all consigned. Adherence was evaluated using the Compliance Questionnaire Rheumatology questionnaire 5-item summary version (CQR5). Statistical analysis: descriptive statistics. Chi2 test or Fisher’s exact test; Survival of treatment by Kaplan-Meier and log Rank. Multiple logistic regression. A p value <0.05 was considered significant.

Promoter hypermethylation of GPX3 as a predictor for chemoresistance and survival in head and neck cancer patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6027-6027 ◽  
Author(s):  
Z. Guo ◽  
Z. Chen ◽  
Z. Yang ◽  
L. Schumaker ◽  
K. J. Cullen
Keyword(s):  
Head And Neck Cancer ◽  
Survival Analysis ◽  
Relative Risk ◽  
Head And Neck ◽  
Cancer Cells ◽  
Cell Lines ◽  
Neck Cancer ◽  
Promoter Hypermethylation ◽  
Exact Test ◽  
Kaplan Meier

6027 Background: Resistance of cancer cells to cisplatin and its analogues is the major limitation in clinical application of cisplatin-based chemotherapy. The mechanisms by which cancer cells develop resistance to the drugs are still unclear, and there is no way currently to predict the drug resistance of individual tumors. By genome-wide scanning of hypermethylated genes on head and neck cancer cells, we identified glutathione peroxidase 3 (GPX3) as one of the strong candidates whose promoter hypermethylation may be associated with head and neck chemoresistance. In this study, we investigated the potential predictive value of GPX3 methylation for head and neck cancer chemoresistance and patient prognosis. Methods: Promoter methylation and expression of GPX3 gene in head and neck cancer cell lines were examined by plasmid cloning, bisulfite DNA sequencing, reverse transcription-PCR and Western blot. GPX3 methylation in primary cancer tissues was assessed by real-time methylation-specific PCR (MSP). Forty-six head and neck cancer cases, for which chemotherapy response and survival were known, were selected for analysis. Correlation of GPX3 methylation and chemoresistance was tested using two-sided Fisher’s Exact Test and its prediction for patient survival was assessed using Kaplan-Meier survival analysis. Results: Loss of GPX3 expression was observed in 4 of 8 head and neck cancer cell lines and was consistent with cisplatin resistance. Demethylating treatment of the cell lines negative for GPX3 expression significantly restored its expression. Bisulfite DNA sequencing showed that the 5’ flanking promoter region of GPX3 was heavily hypermethylated in all cell lines with expression-silencing of the gene. In the 46 head and neck cancer cases analyzed by MSP, 15 of 23 non-responding cases (65%) showed GPX3 methylation, while 4 of 23 complete and partial response cases (17%) contained low levels of GPX3 methylation (Relative Risk 3.343, two sided Fisher’s exact test, P=0.002). Kaplan-Meier survival analysis showed a relative risk of death of 1.942 in patients with GPX3 methylation. Conclusions: Our findings suggest that GPX3 methylation is a strong candidate predictor for chemoresistance and prognosis of head and neck cancer patients. No significant financial relationships to disclose.

Effect of surgery and chemotherapy on long-term survival in infants with congenital glioblastoma: an integrated survival analysis

2020 ◽  
Vol 26 (5) ◽  
pp. 563-571 ◽  
Author(s):  
Victor M. Lu ◽  
Kyle P. O’Connor ◽  
Benjamin T. Himes ◽  
Desmond A. Brown ◽  
Cody L. Nesvick ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Gestational Age ◽  
Multivariable Analysis ◽  
Postnatal Period ◽  
Term Survival ◽  
Initial Management ◽  
Exact Test ◽  
Kaplan Meier ◽  
Autopsy Diagnosis

OBJECTIVEGlioblastoma (GBM) during infancy is rare, and the clinical outcomes of congenital GBM are not well understood. Correspondingly, the aim of this study was to present a long-term survivor case from the authors’ institution, and establish an integrated cohort of cases across the published literature to better understand the clinical course of this disease in this setting.METHODSThe authors report the outcomes of an institutional case of congenital GBM diagnosed within the first 3 months of life, and performed a comprehensive literature search for published cases from 2000 onward for an integrated survival analysis. All cases were integrated into 1 cohort, and Kaplan-Meier estimations, Fisher’s exact test, and logistic regression were used to interrogate the data.RESULTSThe integrated cohort of 40 congenital GBM cases consisted of 23 (58%) females and 17 (42%) males born at a median gestational age of 38 weeks (range 22–40 weeks). Estimates of overall survival (OS) at 1 month was 67%, at 1 year it was 59%, and at 10 years it was 45%, with statistically superior outcomes for subgroups in which patients survived to be treated by resection and chemotherapy. In the overall cohort, multivariable analysis confirmed resection (p < 0.01) and chemotherapy (p < 0.01) as independent predictors of superior OS. Gestational age > 38 weeks (p < 0.01), Apgar scores ≥ 7 at 5 minutes (p < 0.01), absence of prenatal hydrocephalus (p < 0.01), and vaginal delivery (p < 0.01) were associated with greater odds of surgical diagnosis versus autopsy diagnosis.CONCLUSIONSCongenital GBM can deviate from the expected poor prognosis of adult GBM in terms of OS. Both resection and chemotherapy confer statistically superior prognostic advantages in those patients who survive within the immediate postnatal period, and should be first-line considerations in the initial management of this rare disease.

Natural history of neuromodulation devices and therapies: a patient-centered survival analysis

2020 ◽  
Vol 132 (5) ◽  
pp. 1385-1391
Author(s):  
Zoe E. Teton ◽  
Daniel Blatt ◽  
Amr AlBakry ◽  
James Obayashi ◽  
Gulsah Ozturk ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Survival Data ◽  
Rapid Development ◽  
Survival Rates ◽  
Therapeutic Benefit ◽  
Patient Centered ◽  
Kaplan Meier ◽  
History Of ◽  
Hardware Failures ◽  
First Time

OBJECTIVEDespite rapid development and expansion of neuromodulation technologies, knowledge about device and/or therapy durability remains limited. The aim of this study was to evaluate the long-term rate of hardware and therapeutic failure of implanted devices for several neuromodulation therapies.METHODSThe authors performed a retrospective analysis of patients’ device and therapy survival data (Kaplan-Meier survival analysis) for deep brain stimulation (DBS), vagus nerve stimulation (VNS), and spinal cord stimulation (SCS) at a single institution (years 1994–2015).RESULTSDuring the study period, 450 patients underwent DBS, 383 VNS, and 128 SCS. For DBS, the 5- and 10-year initial device survival was 87% and 73%, respectively, and therapy survival was 96% and 91%, respectively. For VNS, the 5- and 10-year initial device survival was 90% and 70%, respectively, and therapy survival was 99% and 97%, respectively. For SCS, the 5- and 10-year initial device survival was 50% and 34%, respectively, and therapy survival was 74% and 56%, respectively. The average initial device survival for DBS, VNS, and SCS was 14 years, 14 years, and 8 years while mean therapy survival was 18 years, 18 years, and 12.5 years, respectively.CONCLUSIONSThe authors report, for the first time, comparative device and therapy survival rates out to 15 years for large cohorts of DBS, VNS, and SCS patients. Their results demonstrate higher device and therapy survival rates for DBS and VNS than for SCS. Hardware failures were more common among SCS patients, which may have played a role in the discontinuation of therapy. Higher therapy survival than device survival across all modalities indicates continued therapeutic benefit beyond initial device failures, which is important to emphasize when counseling patients.

scholarly journals AB0740 SECOND-LINE BIOLOGIC DMARDs SURVIVAL IN PSORIATIC ARTHRITIS. DATA FROM A SPANISH THIRD-LEVEL HOSPITAL.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1665.2-1666
Author(s):  
J. Arroyo Palomo ◽  
I. Del Bosque Granero ◽  
A. Corral Bote ◽  
B. A. Blanco Cáceres ◽  
J. Bachiller-Corral
Keyword(s):  
Survival Analysis ◽  
Psoriatic Arthritis ◽  
Second Line ◽  
Hla B27 ◽  
First Line ◽  
Drug Survival ◽  
Kaplan Meier ◽  
Level Hospital ◽  
Necrosis Factor ◽  
Axial Involvement

Background:Psoriatic arthritis (PsA) covers a wide spectrum of disease manifestations, including arthritis, enthesitis, dactylitis and axial spondylitis. This range of symptoms presents a challenge to the treating physician. Biologic disease-modifying antirheumatic drugs (bDMARDs) have proven effective through randomized clinical trials; and most international PsA guides include them as main option upon first-line treatment failure. However, studies regarding drug efficacy after bDMARD switching are scarce, lower response rates and drug survival on consecutive lines has been explored in previous research.Objectives:To assess bDMARDs survival after first-line failure in PsA patients treated in a third-level hospital and to determine baseline clinical and laboratory parameters associated with drug survival.Methods:We conducted a retrospective, single-centre study. 47 patients who received a second-line bDMARD were included, with diagnosis of PsA according to the criteria of an expert rheumatologist. All patients were studied according to a standard protocol. Data regarding bDMARD prescribed, baseline characteristics, axial or peripheral involvement and immunological profile (included both HLA-B27 and HLA-Cw6) were extracted. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) at bDMARD start were included, as well. Kaplan-Meier, log-rank analyses and Cox regression models were applied.Results:Of 47 patients receiving a second bDMARD, 55,3% (26) were female and mean (S.D.) age was 40,6 (12,52) years. Median (interquartile range) disease duration was 10,1 (3,7-14,8) years. Prescribed drugs were Adalimumab (ADL) (36,2%, 17), Etanercept (ETN) (27,6%, 13), Infliximab (IFX) (6,4%, 3), Golimumab (GOL) (10,6%, 5), Certolizumab (CTZ) (4,3%, 2), Secukinumab (SCK) (8,5%, 4) and Apremilast (APR) (6,4%, 3). 42,3% cases suffered from axial involvement, rest of the sample (57,6%) presented a pure peripherical form of PsA. HLA-B27 and -Cw6 were assessed in 80,9% (38) and 68,1% (32), respectively; of whom, HLA-B27 carriers were 10,5% and HLA-Cw6 positive, 46,9%. Mean CRP level was 10,25 mg/L and mean ESR was 23,17 mm. Patients showed mean and median global drug retention of 44,57 (29,8-59,3) and 23 months. At 12-month visit, drug survival was 70%, 47% at 24 months, and 33% at 4 years from onset. Mean drug persistence by bDMARD prescribed was: ADL, 62,1 months; ETN, 51,9 months; IFX, 39 months; GOL, 22,8 months; CTZ, 9,5 months; SCK, 13,5 months; and APR, 16,3 months. Through log-rank analyses, differences in drug retention were investigated by several variables. Female sex (30,35m, 16,5-44,2 m.) was identified as statistically significant different than male patients (62,5m, 35,6-89,4m, p=0,021). Although not significant, other differences were remarkable: non-axial involvement, HLA-Cw6 negativity, HLA-B27 positivity and CRP level over 5 mg/L. No differences were found between altered and normal ESR patients.Conclusion:Second-line bDMARD survival is lower in female PsA patients, according to our data and previous bibliography. Despite our reduced sample and possible bias, non-axial involvement, absence of HLA-Cw6, presence of HLA-B27 and higher levels of CRP at biologic onset might be predictors of better drug persistence. Further investigations are required on this field.References:[1]Glintborg B et al. Clinical Response, Drug Survival, and Predictors Thereof Among 548 Patients With Psoriatic Arthritis Who Switched Tumor Necrosis Factor α Inhibitor Therapy. Results from the Danish Nationwide DANBIO Registry. Arthritis Rheum 2013:65(5):1213-23.[2]Stober C et al. Prevalence and predictors of tumour necrosis factor inhibitor persistence in psoriatic arthritis. Rheumatology (Oxford) 2018:57(1):158-163.Table 1. Kaplan–Meier survival analysis of persistence according to sex.Table 2. Kaplan Meier survival analysis of persistence according to HLA-Cw6.Disclosure of Interests:None declared

scholarly journals Drug retention rates and relevant risk factors for drug discontinuation due to adverse events in rheumatoid arthritis patients receiving anticytokine therapy with different target molecules

2012 ◽  
Vol 71 (11) ◽  
pp. 1820-1826 ◽  
Author(s):  
Ryoko Sakai ◽  
Michi Tanaka ◽  
Toshihiro Nanki ◽  
Kaori Watanabe ◽  
Hayato Yamazaki ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Events ◽  
Clinical Status ◽  
Good Control ◽  
Biological Agents ◽  
Retention Rates ◽  
Drug Discontinuation ◽  
Drug Retention ◽  
Kaplan Meier ◽  
Frequent Reason

ObjectiveTo compare reasons for discontinuation and drug retention rates per reason among anticytokine therapies, infliximab, etanercept and tocilizumab, and the risk of discontinuation of biological agents due to adverse events (AE) in patients with rheumatoid arthritis (RA).MethodThis prospective cohort study included Japanese RA patients who started infliximab (n=412, 636.0 patient-years (PY)), etanercept (n=442, 765.3 PY), or tocilizumab (n=168, 206.5 PY) as the first biological therapy after their enrolment in the Registry of Japanese Rheumatoid Arthritis Patients for Long-term Safety (REAL) database. Drug retention rates were calculated using the Kaplan–Meier method. To compare risks of drug discontinuation due to AE for patients treated with these biological agents, the Cox proportional hazard model was applied.ResultsThe authors found significant differences among the three therapeutic groups in demography, clinical status, comorbidities and usage of concomitant drugs. Development of AE was the most frequent reason for discontinuation of biological agents in the etanercept and tocilizumab groups, and the second most frequent reason in the infliximab group. Discontinuation due to good control was observed most frequently in the infliximab group. Compared with etanercept, the use of infliximab (HR 1.69; 95% CI 1.14 to 2.51) and tocilizumab (HR 1.98; 95% CI 1.04 to 3.76) was significantly associated with a higher risk of discontinuation of biological agents due to AE.ConclusionsReasons for discontinuation are significantly different among biological agents. The use of infliximab and tocilizumab was significantly associated with treatment discontinuation due to AE compared with etanercept.

scholarly journals Análise de sobrevida de mulheres com câncer de mama

2018 ◽  
Vol 12 (1) ◽  
pp. 59
Author(s):  
Jenika Ferreira Dias ◽  
Natália Silva Martins ◽  
Clícia Valim Côrtes Gradim
Keyword(s):  
Breast Cancer ◽  
Survival Analysis ◽  
Survival Rate ◽  
Cáncer De Mama ◽  
Exact Test ◽  
Screening Programs ◽  
Kaplan Meier ◽  
Las Mujeres ◽  
Quantitative Descriptive ◽  
Project Data

RESUMOObjetivo: avaliar a sobrevida, em cinco anos, de mulheres com câncer de mama. Método: estudo quantitativo, descritivo, exploratório, documental, constituído de 62 prontuários de mulheres atendidas em um Projeto de Extensão. Os dados foram analisados pelo Teste Exato de Fisher, Curva de Kaplan Meier e software R. Resultados: 61,29% (n=38) tiveram câncer de mama com idade entre 50-69 anos; 35,49% (n=22) foram acometidas por metástase; 37,1% (n=23) delas morreram, sendo que a maior causa foi o câncer de mama 87% (n=54). A sobrevida foi de 80%, com tempo médio de 11,27 anos. As mulheres que tiveram metástase possuíam 3,67 mais chances de morrer (p=0,00658), por isso, elas tiveram uma sobrevida menor (p= 00171). Conclusão: a incidência do câncer de mama foi maior em pacientes com faixa etária de 50-69 anos, o que está em acordo com a cobertura de programas de rastreamento preconizados pelo Ministério da Saúde. Descritores: Neoplasias da Mama; Análise de Sobrevida; Enfermagem Oncológica.  ABSTRACTObjective: to evaluate the survival, in five years, of women with breast cancer. Method: quantitative, descriptive, exploratory, documental study, consisting of 62 charts of women attended in an Extension Project. Data were analyzed by Fisher's Exact Test, Kaplan Meier Curve and software R. Results: 61.29% (n = 38) had breast cancer aged 50-69 years; 35.49% (n = 22) were metastasized; 37.1% (n = 23) of them died, and the greatest cause was 87% breast cancer (n = 54). The survival rate was 80%, with an average time of 11.27 years. Women who had metastases had 3.67 more chances of dying (p = 0.00658), therefore, they had a shorter survival (p = 00171). Conclusion: the incidence of breast cancer was higher in patients aged 50-69 years, which is in agreement with the coverage of screening programs recommended by the Ministry of Health. Descriptors: Breast neoplasms; Survival analysis; Oncology Nursing.RESUMENObjetivo: evaluar la supervivencia, en cinco años, de mujeres con cáncer de mama. Método: estudio cuantitativo, descriptivo, exploratorio, documental, constituido de 62 prontuarios de mujeres atendidas en un Proyecto de Extensión. Los datos fueron analizados por la Prueba Exacta de Fisher, Curva de Kaplan Meier y software R. Resultados: 61.29% (n = 38) tuvieron cáncer de mama con edad de 50-69 años; El 35.49% (n = 22) fueron acometidas por metástasis; 37.1% (n = 23) de ellas murieron, siendo que la mayor causa fue el cáncer de mama 87% (n = 54). La sobrevida fue del 80%, con tiempo promedio de 11.27 años. Las mujeres que tuvieron metástasis tenían 3.67 más veces de morir (p = 0.00658), por lo, que tuvieron una supervivencia menor (p = 00171). Conclusión: la incidencia del cáncer de mama fue mayor en pacientes con edades de 50-69 años, lo que está en acuerdo con la cobertura de programas de rastreo preconizados por el Ministerio de Salud. Descriptores: Neoplasias de la Mama; Análisis de la Supervivência; Enferméria Oncológica.

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