Factors predicting pain and early discontinuation of tumour necrosis factor-α-inhibitors in people with rheumatoid arthritis: results from the British society for rheumatology biologics register

McWilliams, Daniel F.; Walsh, David A.

doi:10.1186/s12891-016-1192-7

Table 5 Logistic regression for discontinuation of TNFα-inhibitors within 1 year of their initiation

From: Factors predicting pain and early discontinuation of tumour necrosis factor-α-inhibitors in people with rheumatoid arthritis: results from the British society for rheumatology biologics register

		Discontinuation of TNFα-inhibitors
Variable at baseline	Tertile or group at baseline	All reasons				Lack of Efficacy				Adverse Drug Reaction
		Complete case		Imputed		Complete case		Imputed		Complete case		Imputed
		aOR (95 % CI)	p	aOR (95 % CI)	p	aOR (95 % CI)	p	aOR (95 % CI)	p	aOR (95 % CI)	p	aOR (95 % CI)	p
Age	Tertiles	1.03 (0.96 - 1.10)	0.384	1.04 (0.98 - 1.11)	0.155	0.99 (0.90 - 1.09)	0.856	1.02 (0.94 - 1.11)	0.643	1.07 (0.98 - 1.17)	0.149	1.10 (1.02 - 1.19)	0.020
Gender	Female	1.12 (0.99 - 1.27)	0.062	1.16 (1.04 - 1.28)	0.007	1.18 (0.99 - 1.40)	0.063	1.18 (1.02 - 1.37)	0.029	1.11 (0.94 - 1.32)	0.212	1.14 (0.99 - 1.32)	0.077
BMI	WHO	0.99 (0.93 - 1.05)	0.673	0.98 (0.93 - 1.04)	0.538	1.03 (0.94 - 1.12)	0.540	1.01 (0.93 - 1.09)	0.826	0.94 (0.86 - 1.03)	0.173	0.94 (0.87 - 1.02)	0.141
Smoking	Current	1.24 (1.09 - 1.42)	0.002	1.23 (1.09 - 1.38)	0.001	1.25 (1.04 - 1.50)	0.017	1.21 (1.03 - 1.43)	0.019	1.23 (1.02 - 1.47)	0.031	1.19 (1.02 - 1.40)	0.033
Smoking	Ex	1.07 (0.96 - 1.21)	0.237	1.08 (0.98 - 1.20)	0.101	1.02 (0.87 - 1.21)	0.791	1.05 (0.91 - 1.21)	0.489	1.12 (0.96 - 1.32)	0.151	1.13 (0.99 - 1.30)	0.081
DAS28	Tertiles	1.04 (0.98 - 1.11)	0.226	1.02 (0.96 - 1.07)	0.580	1.08 (0.99 - 1.19)	0.087	1.04 (0.97 - 1.13)	0.285	1.02 (0.93 - 1.11)	0.711	0.99 (0.91 - 1.07)	0.738
DAS28-P	Tertiles	0.99 (0.93 - 1.05)	0.719	0.98 (0.93 - 1.04)	0.567	0.96 (0.88 - 1.05)	0.410	0.98 (0.91 - 1.06)	0.549	0.99 (0.91 - 1.08)	0.876	1.00 (0.93 - 1.08)	0.993
Duration	Tertiles	0.98 (0.92 - 1.05)	0.626	1.01 (0.95 - 1.06)	0.841	0.87 (0.79 - 0.95)	0.002	0.89 (0.82 - 0.96)	0.004	1.09 (1.00 - 1.19)	0.053	1.09 (1.01 - 1.17)	0.037
Serology	Positive	1.04 (0.93 - 1.16)	0.523	1.01 (0.92 - 1.11)	0.830	0.94 (0.81 - 1.09)	0.432	0.92 (0.81 - 1.05)	0.213	1.09 (0.93 - 1.26)	0.283	1.07 (0.94 - 1.21)	0.344
Erosions	Positive	0.93 (0.84 - 1.04)	0.224	0.93 (0.85 - 1.03)	0.151	0.96 (0.83 - 1.12)	0.619	0.95 (0.84 - 1.09)	0.482	0.93 (0.80 - 1.09)	0.368	0.94 (0.82 - 1.07)	0.324
Extra-articular manifestation	Yes	1.17 (1.05 - 1.31)	0.004	1.17 (1.07 - 1.29)	0.001	1.08 (0.93 - 1.27)	0.302	1.06 (0.93 - 1.22)	0.386	1.33 (1.15 - 1.53)	<0.001	1.32 (1.16 - 1.50)	<0.001
Co-morbidity	Yes	1.11 (1.00 - 1.24)	0.059	1.14 (1.04 - 1.25)	0.005	1.12 (0.97 - 1.31)	0.129	1.15 (1.01 - 1.31)	0.040	1.11 (0.95 - 1.28)	0.182	1.13 (1.00 - 1.28)	0.058
HAQ	Tertiles	0.95 (0.89 - 1.01)	0.097	0.97 (0.92 - 1.02)	0.277	0.94 (0.86 - 1.02)	0.143	0.95 (0.88 - 1.03)	0.185	0.94 (0.86 - 1.02)	0.138	0.97 (0.90 - 1.05)	0.444
SF36-Vitality	Tertiles	0.99 (0.92 - 1.06)	0.771	0.98 (0.92 - 1.04)	0.471	1.06 (0.96 - 1.17)	0.248	1.05 (0.96 - 1.14)	0.306	0.96 (0.87 - 1.06)	0.402	0.96 (0.89 - 1.04)	0.304
SF36-Mental Health	Tertiles	1.02 (0.96 - 1.10)	0.531	1.02 (0.96 - 1.08)	0.540	1.00 (0.91 - 1.09)	0.923	1.00 (0.91 - 1.08)	0.900	1.02 (0.94 - 1.12)	0.608	1.02 (0.94 - 1.11)	0.587
SF36-Physical Function	Tertiles	1.14 (1.06 - 1.22)	<0.001	1.15 (1.08 - 1.22)	<0.001	1.07 (0.97 - 1.18)	0.171	1.08 (0.99 - 1.18)	0.082	1.25 (1.14 - 1.38)	<0.001	1.24 (1.14 - 1.35)	<0.001
SF36-Bodily Pain	Tertiles	1.13 (1.05 - 1.22)	0.002	1.12 (1.05 - 1.20)	<0.001	1.23 (1.10 - 1.36)	<0.001	1.22 (1.11 - 1.33)	<0.001	0.99 (0.90 - 1.10)	0.885	1.04 (0.95 - 1.14)	0.389
Steroid	At baseline	0.99 (0.88 - 1.11)	0.796	0.96 (0.87 - 1.06)	0.436	0.98 (0.83 - 1.15)	0.777	0.93 (0.80 - 1.07)	0.288	0.96 (0.81 - 1.13)	0.613	0.94 (0.82 - 1.09)	0.380
Methotrexate	At baseline	0.69 (0.61 - 0.78)	<0.001	0.70 (0.63 - 0.78)	<0.001	0.73 (0.61 - 0.87)	<0.001	0.70 (0.60 - 0.82)	<0.001	0.60 (0.50 - 0.71)	<0.001	0.58 (0.50 - 0.67)	<0.001
Sulphasalazine	At baseline	0.74 (0.63 - 0.86)	<0.001	0.74 (0.65 - 0.84)	<0.001	0.85 (0.69 - 1.04)	0.111	0.81 (0.68 - 0.97)	0.024	0.61 (0.49 - 0.77)	<0.001	0.66 (0.55 - 0.80)	<0.001
Lefunomide	At baseline	1.07 (0.88 - 1.30)	0.524	1.01 (0.85 - 1.19)	0.928	1.36 (1.05 - 1.75)	0.019	1.19 (0.95 - 1.49)	0.133	0.86 (0.65 - 1.13)	0.267	0.88 (0.69 - 1.11)	0.262
Hydroxychloroquine	At baseline	0.82 (0.68 - 0.98)	0.032	0.85 (0.73 - 1.00)	0.046	0.87 (0.67 - 1.12)	0.273	0.90 (0.73 - 1.13)	0.364	0.79 (0.61 - 1.04)	0.134	0.88 (0.71 - 1.10)	0.274
Gold	At baseline	0.62 (0.41 - 0.95)	0.026	0.70 (0.48 - 1.01)	0.055	0.60 (0.32 - 1.10)	0.097	0.68 (0.40 - 1.16)	0.161	0.65 (0.37 - 1.14)	0.613	0.66 (0.40 - 1.11)	0.115

Three multi-variable adjusted logistic regression models for TNFα-inhibitor discontinuation at 1 year using data from 20 imputed datasets at baseline (table contains all variables included in the models). Continuous variables divided into tertiles except for body mass index (BMI). For each variable, the highest tertile is that which signifies worst health (including SF36 variables, which have been reversed). Significant results are highlighted in bold

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