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We explore persistence of etanercept monotherapy and monotherapy with other tumor necrosis factor inhibitors (TNFis) among patients first achieving remission\/low disease activity (LDA) while on combination therapy with csDMARDs and a TNFi. Using Corrona registry data, the percentage of patients persistent with the index TNFi (etanercept versus other TNFis) over 6 and 12\u00a0months was determined. Factors influencing persistence and treatment patterns at 6 and 12\u00a0months were examined. Among 617 eligible patients, 56% of 182 patients on etanercept and 45% of 435 patients on other TNFis persisted with monotherapy at 6\u00a0months, 46% and 33%, respectively, at 12\u00a0months. Across first-line and subsequent biologic DMARDs, etanercept persistence was greater than other TNFi persistence by 10.8% (95% CI 2.1%, 19.6%) at 6\u00a0months and 11.4% (95% CI 0.9%, 21.9%) at 12\u00a0months. Patients on other TNFis were more likely to require reintroduction of csDMARD after 6\u00a0months (45% versus 35% for etanercept). Remission was the key predictor of persistence for both etanercept and other TNFi monotherapies. This retrospective, cohort study of registry data reflecting real-world practice indicates patients who achieve remission\/LDA with combination csDMARD and TNFi therapy may successfully transition to TNFi monotherapy. Patients on etanercept monotherapy experienced greater persistence and less frequent reintroduction of a csDMARD than was observed for patients on other TNFi monotherapies.<\/jats:p>","DOI":"10.1007\/s00296-020-04667-5","type":"journal-article","created":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T05:02:22Z","timestamp":1599022942000},"page":"381-390","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Persistence on biologic DMARD monotherapy after achieving rheumatoid arthritis disease control on combination therapy: retrospective analysis of corrona registry data"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8338-027X","authenticated-orcid":false,"given":"Dimitrios A.","family":"Pappas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3511-4078","authenticated-orcid":false,"given":"Heather J.","family":"Litman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Lesperance","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9419-9836","authenticated-orcid":false,"given":"Greg","family":"Kricorian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8520-2549","authenticated-orcid":false,"given":"Elaine","family":"Karis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0201-4030","authenticated-orcid":false,"given":"Sabrina","family":"Rebello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5222-9187","authenticated-orcid":false,"given":"Winnie","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0522-0769","authenticated-orcid":false,"given":"Neil A.","family":"Accortt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0404-4487","authenticated-orcid":false,"given":"Scott","family":"Stryker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,2]]},"reference":[{"issue":"13","key":"4667_CR1","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1001\/jama.2018.13103","volume":"320","author":"D Aletaha","year":"2018","unstructured":"Aletaha D, Smolen JS (2018) Diagnosis and management of rheumatoid arthritis: a review. 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Pappas is an employee of Corrona, LLC; has been a consultant\/received honoraria for Novartis, Genentech\/Roche, Sanofi\/Regeneron, and AbbVie; has equity interest in Corrona, LLC; and is on the board of directors for Corrona Research Foundation. Heather Litman is an employee and shareholder at Corrona, LLC; Tamara Lesperance is a contractor for and has received salary support from Amgen Inc.; Greg Kricorian is an employee and shareholder of Amgen Inc.; Elaine Karis is an employee and shareholder of Amgen Inc.; Sabrina Rebello is an employee of Corrona, LLC. Winnie Hua is an employee of Corrona, LLC. Neil A. Accortt is an employee and shareholder of Amgen Inc. Scott Stryker is an employee and shareholder of Amgen Inc.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All participating investigators obtained full institutional review board (IRB) approval for human subject research. Sponsor approval and continuing review were obtained through a central IRB (New England Independent Review Board, NEIRB No. 120160610; approved annually on July 28, 2016; July 27, 2017; August 7, 2018; and July 30, 2019). For academic investigative sites without a waiver to use the central IRB, full board approval was obtained from the respective governing IRBs; documentation of approval was submitted to the Sponsor before initiating any study procedures.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All registry participants provided written informed consent before participating.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The Corrona dataset is based on a large US multicenter study adhering to a number of institutional review boards, with complex logistics. Patients did not provide consent to raw data sharing during the data collection for this purpose, and the Corrona data sharing policies do not permit raw data sharing for this purpose. An aggregated limited dataset from the current analyses is available to qualified investigators with an approved protocol. Data requests may be sent to Corrona, represented by Dr. Jeffrey D. Greenberg, MD, MPH, New York University School of Medicine, New York, NY, e-mail jgreenberg@corrona.org.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data sharing"}}]}}