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Original Article
DOI: 10.1016/j.reumae.2020.11.003
Available online 21 July 2021
Adherence to treatment with tofacitinib in patients with rheumatoid arthritis in daily clinical practice
Adherencia al tratamiento con tofacitinib en pacientes con artritis reumatoide en la práctica clínica diaria
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Tatiana Barbich, Osvaldo Luis Cerda, Emilce Edith Schneeberger, Gustavo Citera
Corresponding author
gustavocitera@gmail.com

Corresponding author.
Instituto de Rehabilitación Psicofísica (IREP), Ciudad de Buenos Aires, Argentina
Received 17 June 2020. Accepted 01 November 2020
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Tables (4)
Table 1. Sociodemographic, medical and therapeutic characteristics of the population under study.
Table 2. Variables associated with the presence or absence of adherence (CQR19 ≥ 80%).
Table 3. Variables associated with adherence to treatment with tofacitinib in patients with rheumatoid arthritis according to CQR19 (≥80%). Multiple logistic regression.
Table 4. Consistency of adherence to treatment with tofacitinib between the CQR19 (≥80%) and CQR5 (≥80%).
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Abstract
Objectives

To evaluate the adherence to treatment with Tofacitinib in patients with Rheumatoid Arthritis (RA) using two versions of the self-questionnaire Compliance Questionnaire Rheumatology, CQR19 and CQR5, to determine the variables associated with adherence to Tofacitinib and to compare the performance of both questionnaires.

Material and methods

A cross-sectional study was carried out. We included patients ≥18 years old, with RA (ACR/EULAR criteria 2010) under treatment with Tofacitinib. Sociodemographic data, clinical characteristics, treatment and data on patient evaluation. All the patients completed self-questionnaires CQR19 and CQR5. Statistical analysis: Descriptive statistics. t-Test or Mann Whitney to compare the continuous variables, Chi2 test or Fisher's exact test for the categorical ones. Kappa concordance index. Multiple logistic regression.

Results

We included 52 patients, 82.7% women, with a median (m) age of 57.7 years, disease duration m 16 years, 63.5% had comorbidities. Of the patients, 86.5% were treated with Tofacitinib (5 mg BID) and 48% received Tofacitinib as monotherapy. The median time of Tofacitinib treatment was 13 months, 42.3% suspended treatment, and only one patient permanently stopped treatment due to lack of provision. Median CQR19 was 89.5% and 84.6% had an adherence ≥ 80%. The variables significantly associated with adherence ≥ 80% were the presence of comorbidities (p = .014) and older age (p = .033). Considering the CQR5, a similar percentage of patients (82.7%) were adherents to treatment, however, the concordance with CQR19 was low. In the multivariate analysis, older age was the only variable independently associated with good adherence to treatment.

Conclusions

Treatment adherence to Tofacitinib was very good for both presentations. Older age was associated with higher adherence. The agreement between the questionnaires CQR19 and CQR5 was low.

Keywords:
Rheumatoid arthritis
Adherence
Tofacitinib
Resumen
Objetivos

Evaluar la adherencia al tratamiento con Tofacitinib en pacientes con Artritis Reumatoidea (AR) mediante las dos versiones del autocuestionario Compliance Questionnaire Rheumatology, CQR19 y CQR5, determinar las variables asociadas a la adherencia a Tofacitinib y comparar el rendimiento de ambos cuestionarios.

Material y métodos

Estudio de corte transversal. Se incluyeron pacientes ≥18 años de edad, con AR (ACR/EULAR 2010) en tratamiento con Tofacitinib. Se consignaron datos sociodemográficos, características clínicas de la enfermedad, tratamientos y datos sobre la evaluación de los pacientes. Todos los pacientes completaron los autocuestionarios CQR19 y CQR5. Análisis estadístico: Estadística descriptiva. T-test o Mann Whitney para variables continuas y test de Chi2 o test exacto de Fisher para las categóricas. Índice de concordancia Kappa. Regresión logística múltiple.

Resultados

Se incluyeron 52 pacientes, 82,7% mujeres, con una edad mediana (m) de 57,7 años, tiempo de evolución de la enfermedad m 16 años. 63,5% presentaban comorbilidades. El 86,5% de los pacientes estaban tratados con Tofacitinib (5 mg dos veces /día) y el 48% recibía Tofacitinib en monoterapia. El tiempo m de tratamiento con Tofacitinib fue de 13 meses. 42,3% suspendieron el tratamiento y un sólo paciente suspendió definitivamente por falta de provisión. La m de CQR19 fue de 89,5% y 84,6% de los pacientes presentaron adherencia ≥ al 80%. Las variables significativamente asociadas con adherencia ≥80%, fueron la presencia de comorbilidades (p = 0,014) y mayor edad (p = 0,033). Considerando el CQR5, un porcentaje similar de pacientes (82,7%) fueron adherentes al tratamiento, sin embargo, la concordancia con CQR19 fue baja (??: 0,227). En el análisis multivariado, mayor edad fue la única variable independientemente asociada a buena adherencia al tratamiento (p = 0,037).

Conclusiones

La adherencia al tratamiento con Tofacitinib, en ambas formulaciones, fue muy buena. Mayor edad se asoció con mejor adherencia al tratamiento. La concordancia entre los cuestionarios CQR19 y CQR5 fue baja.

Palabras clave:
Artritis reumatoidea
Adherencia
Tofacitinib

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