Adherence to Treatment with Tofacitinib in Patients with Rheumatoid Arthritis in Daily Clinical Practice

Tatiana Barbich; Osvaldo Luis Cerda; Emilce Edith Schneeberger; Gustavo Citera

doi:10.1016/j.reuma.2020.11.003

Adherence to Treatment with Tofacitinib in Patients with Rheumatoid Arthritis in Daily Clinical Practice

Reumatol Clin (Engl Ed). 2021 Jan 15:S1699-258X(20)30274-6. doi: 10.1016/j.reuma.2020.11.003. Online ahead of print.

[Article in English, Spanish]

Authors

Tatiana Barbich¹, Osvaldo Luis Cerda¹, Emilce Edith Schneeberger¹, Gustavo Citera²

Affiliations

¹ Instituto de Rehabilitación Psicofísica (IREP), Ciudad de Buenos Aires, Argentina.
² Instituto de Rehabilitación Psicofísica (IREP), Ciudad de Buenos Aires, Argentina. Electronic address: gustavocitera@gmail.com.

PMID: 33461871
DOI: 10.1016/j.reuma.2020.11.003

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 ≥18years 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 57.7years, disease duration m 16years, 63.5% had comorbidities. Of the patients, 86.5% were treated with tofacitinib (5mg BID) and 48% received tofacitinib as monotherapy. The median time of tofacitinib treatment was 13months, 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: Adherence; Adherencia; Artritis reumatoide; Rheumatoid arthritis; Tofacitinib.