Infusion/injection site reaction was highest with IFX (1.38/100 patient-years). Cox regression revealed increasing age, female sex, not having a diagnosis of spondyloarthritis (SpA) and IFX use were significantly associated with drug withdrawal for either inefficacy or SAEs. Rheumatoid arthritis (RA) had the highest hazard ratio for drug withdrawal but SpA was favorable for drug retention, after adjustment for age, sex, disease duration and the choice of anti-TNFα agents. In our registry, the retention
rate of the anti-TNFα agents was lowest but the incidence of tuberculosis, serious infections and infusion reaction was highest with IFX. Older female Doramapimod ic50 patients with RA and the use of IFX were independently associated with drug withdrawal. Rheumatological MG132 disorders belong to a group of chronic immune-mediated inflammatory diseases that are associated with significant morbidity and mortality.[1] Prototype rheumatic diseases like systemic lupus erythematous (SLE) and the inflammatory arthritides that include rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PSA) affect multiple organ systems of the body in
addition to the musculoskeletal system. RA, SpA and PSA are progressive and destructive diseases that may result in irreversible damage of the musculoskeletal system, leading to loss of function, disability and impairment of quality of life.[2-4] Rheumatic diseases are a major cause of work disability in the younger population and contribute to a considerable economic burden.[5-7] Moreover, the chronic inflammatory process and its therapies is associated with an increased risk of comorbidities such as cardiovascular disease, cerebrovascular disease, infection and malignancies that contribute to a shortened life expectancy.[1] Information from 19 public Dynein government hospitals in Hong Kong retrieved by the hospital database revealed that the age and sex adjusted standardized mortality ratio (SMR) of RA, SpA and PSA was 1.68,
1.87 and 1.59, respectively, as compared to the general population.[1] There was reduced life expectancy of 7 years in male and 5 years in female patients with RA. The corresponding figures for SpA in male patients and PSA in women were 7.0 and 6.5 years, respectively. The major causes of death of patients with rheumatic diseases were infection, cancer, cardiovascular and cerebrovascular diseases.[1] The treatment of rheumatic diseases has undergone a major revolution in the past decade. This is related to the availability of a number of biological agents that specifically target certain pathways of the inflammatory cascade. Randomized controlled trials have clearly shown benefits of these novel agents in the treatment of RA, SpA and PSA as compared to conventional therapies.[8-10] In Hong Kong, four anti-TNFα agents, namely infliximab (IFX), etanercept (ETN), adalimumab (ADA) and golimumab (GLM), are currently available for the treatment of RA, SpA and PSA.