Comparison of the drug retention and reasons for discontinuation of tumor necrosis factor inhibitors and interleukin-6 inhibitors in Japanese patients with elderly-onset rheumatoid arthritis—the ANSWER cohort study

Abstract Background This multi-center, retrospective study aimed to clarify retention rates and reasons for discontinuation of either tumor necrosis factor inhibitors (TNFi) or interleukin-6 (IL-6i) in patients with elderly-onset rheumatoid arthritis (EORA). Methods Patients (RA) enrolled a Japanese multicenter observational registry between 2011 2020 were included. EORA was defined as RA onset at 60 over. To adjust confounding by indication treatment TNFi IL-6i, propensity score based on multiple baseline characteristics variables used compare the drug causes IL-6i. Adjusted cumulative incidence each reason compared two groups using Fine-Gray model. Results Among total 9,550 registry, 674 297 IL-6i initiators identified. Age, proportion females, disease duration, activity time initiation similar groups. After adjusting differences groups, overall significantly lower (HR = 0.71, 95%CI 0.59–0.86, p < 0.001). The adjusted due lack effectiveness 0.46, 0.33–0.63, 0.001) while those adverse events 0.82, 0.56–1.18, 0.28) achievement clinical remission 1.09, 0.62–1.91, 0.76) Conclusions In initiating higher observed Discontinuation less frequent discontinuations event