Prior biologic
|
Number (% of all prior biologic DMARDs)
|
Number of switches (% of each prior biologic DMARD)
|
Adjusteda OR of any switch (95% CI)
|
Switch to TNF or to non-TNF inhibitorsb
|
---|
Number of switches to TNF inhibitors (%)
|
Number of switches to non-TNF inhibitors (%)
|
---|
TNF inhibitors
|
Etanercept
|
11,753 (50.6)
|
1223 (10.4)
|
Reference
|
989 (80.9)
|
234 (19.1)
|
Adalimumab
|
5119 (22.0)
|
732 (14.3)
|
1.22 (1.10, 1.35)
|
573 (78.3)
|
159 (21.7)
|
Certolizumab
|
104 (0.4)
|
20 (19.2)
|
1.44 (0.86, 2.39)
|
8 (40.0)
|
12 (60.0)
|
Golimumab
|
130 (0.6)
|
35 (26.9)
|
2.24 (1.48, 3.37)
|
22 (62.9)
|
13 (37.1)
|
Infliximab
|
5102 (22.0)
|
567 (11.1)
|
1.06 (0.95, 1.19)
|
377 (66.5)
|
190 (33.5)
|
Non-TNF inhibitor biologic agents
|
Abatacept
|
407 (1.8)
|
70 (17.2)
|
1.31 (0.99, 1.72)
|
40 (57.1)
|
30 (42.9)
|
Anakinra
|
260 (1.1)
|
85 (32.7)
|
3.20 (2.41, 4.25)
|
79 (92.9)
|
6 (7.1)
|
Rituximab
|
334 (1.4)
|
27 (8.1)
|
0.57 (0.38, 0.85)
|
16 (59.3)
|
11 (40.7)
|
Tocilizumab
|
22 (0.1)
|
2 (9.1)
|
0.59 (0.14, 2.60)
|
0 (0.0)
|
2 (100)
|
Total
|
23231 (100)
|
2761 (11.9)
|
—
|
743 (76.2)
|
657 (23.8)
|
-
DMARD disease-modifying antirheumatic drug. aAdjusted for demographics, data source, calendar year, comorbidities, history of medication use, and healthcare utilization in the baseline period. bTNF inhibitors include adalimumab, certolizumab, etanercept, golimumab, and infliximab; non-TNF inhibitors include abatacept, anakinra, rituximab, and tocilizumab