{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:26:40Z","timestamp":1785767200447,"version":"3.56.0"},"reference-count":40,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T00:00:00Z","timestamp":1722384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AbbVie Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: The objective of this study was to evaluate the real-world drug survival, adherence, and discontinuation risk of biologics disease-modifying anti-rheumatic drugs (bDMARDs) among patients with ankylosing spondylitis (AS). Methods: This was a retrospective study using a computerized database. Biologic-na\u00efve and biologic-experienced AS patients who initiated treatment with bDMARDs (tumor necrosis factor alpha inhibitors {TNF-\u03b1is} or interleukin-17 inhibitor {IL-17i}) during 2015\u20132018 were included. Adherence was assessed using the proportion of days covered (PDC) method. Drug survival was analyzed using Kaplan\u2013Meier estimates. Risk of discontinuation was estimated by the Cox proportional hazard model. Results: We identified 343 eligible patients utilizing 481 lines of therapy. The mean age was 44.6 years (SD \u00b1 13.4), 57.7% were males, and 69.7% were biologic-na\u00efve at baseline. The proportion of highly adherent patients (PDC \u2265 0.8) in the biologic-na\u00efve group was 63.5% for golimumab, 69.2% for etanercept, and 71.6% for adalimumab (p &gt; 0.9). Among the biologic-experienced group, secukinumab had the highest proportion of adherent patients (75.7%) and etanercept the lowest (50.0%) reaching statistical difference (p &lt; 0.001). The Kaplan\u2013Meier analysis did not show a significant difference in drug survival in either the biologic-na\u00efve or the biologic-experienced groups (p = 0.85). Multivariable analysis demonstrated a similar risk for discontinuation for etanercept, golimumab, and secukinumab compared with adalimumab, regardless of biologic-experience status. Conclusions: Adherence, drug survival, and risk for discontinuation were similar for all TNF-\u03b1is and the IL-17i SEC, regardless of biologic-experience status. As drug survival is an indirect measure of drug efficacy, n, in real-world settings, we believe caregivers can integrate these results into treatment considerations.<\/jats:p>","DOI":"10.3390\/jcm13154480","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T10:34:43Z","timestamp":1722422083000},"page":"4480","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Real-World Adherence and Drug Survival of Biologics among Patients with Ankylosing Spondylitis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1535-7091","authenticated-orcid":false,"given":"Vered","family":"Rosenberg","sequence":"first","affiliation":[{"name":"Maccabi Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv 6801296, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5406-7716","authenticated-orcid":false,"given":"Howard","family":"Amital","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262000, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5189-8995","authenticated-orcid":false,"given":"Gabriel","family":"Chodick","sequence":"additional","affiliation":[{"name":"Maccabi Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv 6801296, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3535-7152","authenticated-orcid":false,"given":"Freddy","family":"Faccin","sequence":"additional","affiliation":[{"name":"AbbVie Inc., North Chicago, IL 60064, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1404-8027","authenticated-orcid":false,"given":"Abdulla","family":"Watad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262000, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"McGonagle","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS9 7JT, UK"},{"name":"Leeds Musculoskeletal Biomedical Research Centre, Chapel Allerton Hospital, Leeds LS7 4SA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Gendelman","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262000, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"236","DOI":"10.4329\/wjr.v7.i9.236","article-title":"Ankylosing spondylitis: A state of the art factual backbone","volume":"7","author":"Attaya","year":"2015","journal-title":"World J. 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