Few studies have compared the efficacy of switching from etanercept to adalimumab in the real-life setting in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). This study evaluated the 2-year retention rate and 12-month efficacy of adalimumab in RA and PsA patients, previously treated with etanercept. RA and PsA patients from 11 Italian Rheumatology Units received adalimumab after first-line etanercept failure. Two-year adalimumab retention rate was calculated by the Kaplan-Meier method and Cox proportional hazard models were developed to examine predictors of drug persistence. Univariate and multivariate logistic regression analyses were developed to examine potential predictors of 12-month DAS-28 remission. The study population included 117 RA (disease duration of 10.1 ± 7.7 years and baseline DAS28-ESR of 4.97 ± 1.3) and 102 PsA (disease duration of 7.1 ± 5.1 years and baseline DAPSA of 24.6 ± 11.8). The 2-year retention rate was 48.2% in RA and 56.5% in PsA patients. Concomitant methotrexate treatment was not associated with increased drug survival in both groups. Similarly, cause of etanercept discontinuation or treatment duration was not associated with retention rate. 12-month remission and low disease activity were achieved, respectively, in 27.3% and 23.9% of RA patients and 27.4% and 23.5% PsA of patients. In multivariate models, etanercept discontinuation due to inefficacy (OR 0.27, 95% CI 1.03-0.73; p = 0.009) and baseline DAS-28 (OR 0.45, 95% CI 0.29-0.69; p < 0.001) remained significant negative predictors of remission in RA patients. No variable was associated with remission in PsA patients. Adalimumab after etanercept failure was highly effective and safe in both RA and PsA patients.

中文翻译：

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一线依那西普治疗失败后，阿达木单抗在类风湿关节炎和银屑病关节炎患者中的疗效和保留率：无恐惧队列。

很少有研究在类风湿性关节炎（RA）和银屑病关节炎（PsA）的现实生活中比较从依那西普转换为阿达木单抗的功效。这项研究评估了先前接受依那西普治疗的RA和PsA患者中阿达木单抗的2年保留率和12个月疗效。一线依那西普失败后，来自意大利11个风湿病科的RA和PsA患者接受了阿达木单抗治疗。通过Kaplan-Meier方法计算了两年的阿达木单抗保留率，并开发了Cox比例风险模型以检查药物持久性的预测因子。单因素和多因素logistic回归分析被开发用来检查DAS-28缓解12个月的潜在预测指标。研究人群包括117 RA（疾病持续时间为10.1±7.7年，基线DAS28-ESR为4.97±1。3）和102 PsA（疾病持续时间7.1±5.1年，基线DAPSA为24.6±11.8）。RA的2年保留率为48.2％，PsA患者为26.5％。两组甲氨蝶呤的同时治疗均与药物生存期延长无关。同样，依那西普停药的原因或治疗时间与保留率无关。RA患者的27.3％和23.9％以及PsA的27.4％和23.5％的患者分别实现了12个月的缓解和较低的疾病活动性。在多变量模型中，因无效而停用依那西普（OR 0.27，95％CI 1.03-0.73; p = 0.009）和基线DAS-28（OR 0.45，95％CI 0.29-0.69; p <0.001）仍然是缓解的显着阴性预测指标在RA患者中。PsA患者的缓解没有相关的变量。