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A prospective analysis of risk factors for the discontinuation of second-line antirheumatic drugs

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Abstract

Clinical and laboratory factors influencing the discontinuation of second-line antirheumatic drugs were prospectively studied using survival analysis in a consecutive series of 245 patients with recently diagnosed rheumatoid arthritis. A statistically significant influence of age, sex, serum IgA and HLA-DR3 on the discontinuation rate of chrysotherapy because of toxicity was observed. The discontinuation of sulfasalazine was increased by advanced age and high rank order of prescription. With respect to efficacy, high initial disease activity appeared to predispose to treatment termination of hydroxychloroquine, sulfasalazine and penicillamine. Furthermore, an influence of the rank order of prescription on discontinuation of sulfasalazine therapy because of lack of efficacy was found. Of interest is that discontinuation of hydroxychloroquine therapy because of lack of efficacy occurred less frequently in HLA-DR3-positive than in HLA-DR3-negative patients. Although these prognostic factors are of secondary importance in clinical practice, they may be of significance in the interpretation and comparison of clinical trials.

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Authors and Affiliations

  1. Department of Rheumatology, University Hospital Nijmegen, P.O. Box 9101, 6500, HB Nijmegen, the Netherlands

    Math J. Wijnands,  Levinus B. A. Van de Putte & Piet L. C. M. Van Riel

  2. Department of Medical Statistics, University Hospital Nijmegen, the Netherlands

    Martin A. Van 't Hof

  3. Department of Rheumatology, University Hospital Groningen, P.O. Box 30001, 9700, RB Groningen, the Netherlands

    Miek A. Van Leeuwen & Martin H. Van Rijswijk

Authors
  1. Math J. Wijnands
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  2. Martin A. Van 't Hof
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  3. Miek A. Van Leeuwen
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  4. Martin H. Van Rijswijk
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  5. Levinus B. A. Van de Putte
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  6. Piet L. C. M. Van Riel
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Wijnands, M.J., Van 't Hof, M.A., Van Leeuwen, M.A. et al. A prospective analysis of risk factors for the discontinuation of second-line antirheumatic drugs. Pharm World Sci 15, 203–207 (1993). https://doi.org/10.1007/BF01880627

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