Cox proportional hazard estimates (95% CI) for anti-TNF therapy discontinuation
| DMARD co-therapy at baseline | Hazard ratios (95% CIs) | |||||
|---|---|---|---|---|---|---|
| Overall stopping | Stopping owing to inefficacy | Stopping owing to adverse events | ||||
| Unadjusted | Adjusted† | Unadjusted | Adjusted† | Unadjusted | Adjusted† | |
| MTX | Reference | |||||
| None | 1.54 (1.43 to 1.65) | 1.40 (1.30 to 1.51) | 1.45 (1.30 to 1.62) | 1.34 (1.20 to 1.51) | 1.69 (1.52 to 1.89) | 1.47 (1.30 to 1.65) |
| SSZ | 1.22 (1.03 to 1.45) | 1.23 (1.03 to 1.47) | 1.34 (1.05 to 1.71) | 1.34 (1.04 to 1.74) | 1.16 (0.88 to 1.52) | 1.21 (0.91 to 1.60) |
| LEF | 1.50 (1.34 to 1.69) | 1.41 (1.25 to 1.59) | 1.64 (1.38 to 1.94) | 1.58 (1.32 to 1.88) | 1.47 (1.22 to 1.76) | 1.34 (1.10 to 1.62) |
| MTX+SSZ | 0.70 (0.62 to 0.79) | 0.76 (0.67 to 0.86) | 0.74 (0.62 to 0.88) | 0.77 (0.64 to 0.92) | 0.59 (0.49 to 0.73) | 0.70 (0.57 to 0.86) |
| MTX+HCQ | 0.78 (0.66 to 0.92) | 0.81 (0.68 to 0.96) | 0.82 (0.65 to 1.05) | 0.83 (0.64 to 1.06) | 0.80 (0.62 to 1.04) | 0.85 (0.66 to 1.11) |
| MTX+SSZ+HCQ | 0.82 (0.70 to 0.96) | 0.80 (0.68 to 0.95) | 0.80 (0.62 to 1.02) | 0.75 (0.58 to 0.96) | 0.83 (0.64 to 1.07) | 0.87 (0.67 to 1.13) |
| p Value* | <0.01 | <0.01 | <0.01 | <0.01 | <0.01 | <0.01 |
↵† Adjusted for baseline age, gender, presence of comorbidities, current smoking, number of previous DMARDs, current steroids, disease duration, baseline DAS28 and baseline HAQ. All models additionally stratified by start year and anti-TNF agent.
↵* Test of significance of difference between the different DMARD co-therapies.
DAS, Disease Activity Score; DMARD, disease modifying antirheumatic drugs; HAQ, Health Assessment Questionnaire; HCQ, hydroxychloroquine; LEF, leflunomide; MTX, methotrexate; SSZ, sulfasalazine; TNF, tumour necrosis factor.