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Adherence and dosing interval of subcutaneous antitumour necrosis factor biologics among patients with inflammatory arthritis: analysis from a Canadian administrative database
  1. Peter Bhoi1,
  2. Louis Bessette2,
  3. Mary J Bell3,
  4. Cathy Tkaczyk1,
  5. Francois Nantel4,
  6. Karina Maslova1
  1. 1 Medical Affairs, Janssen Inc, Toronto, Ontario, Canada
  2. 2 Groupe de Recherche en Rhumatologie et Maladies Osseuses, Sainte-Foy, Quebec, Canada
  3. 3 Department of Rheumatology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  4. 4 Medical Affairs, Janssen Inc, Toronto, Ontario, Canada
  1. Correspondence to Dr Francois Nantel; fnantel{at}


Objectives Subcutaneous tumour necrosis factor alpha TNFαinhibitors (SC-TNFis) such as golimumab (GLM), adalimumab (ADA), etanercept (ETA) and certolizumab pegol (CZP) have been used for many years for the treatment of inflammatory arthritis. Non-adherence to therapy is an important modifiable factor that may compromise patient outcomes. The aim of this analysis was to compare adherence and dosing interval of SC-TNFis in the treatment of people with inflammatory arthritis.

Design We used the IMS Brogan database combining both Canadian private and public drug plan databases of Ontario and Quebec. Target drugs included SC-TNFis for inflammatory arthritis. The index period was from 1 January 2010 to 30 June 2012 and patients were followed for 24 months through 30 June 2014. Inclusion criteria were adult patients newly prescribed a SC-TNFis with at least three prescriptions and retained on therapy at 24 months.

Dosing regimens as per the product monographs were used to compare actual versus expected drug utilisation. The mean possession ratio was used as a marker for adherence. Patients who scored >80% were considered adherent. The average days between units was estimated by taking the total days on therapy and divided by the number of units the patient received.

Results 4035 patients were included: 683 (16.9%), 1400 (34.7%), 1765 (43.7%) and 187 (4.6%) were treated with GLM, ADA, ETA and CZP, respectively. The proportion of adherent patients in the GLM cohort (n=595/683, 87%, p<0.0001) was greater compared with ADA (n=1044/1400, 75%), ETA (n=1285/1765, 73%) and CZP-treated patients (132/187, 71%). In addition, the number of patients receiving biological drug at a shorter dosing interval was similar between cohorts, and was 5%, 6%, 12% and 4% in GLM (≤26 days), ADA (≤12 days), ETA (≤6 days) and CZP-treated patients (≤12 days), respectively.

Conclusions In this real-life administrative database, GLM had better adherence compared with other SC-TNFis.

  • adherence
  • inflammatory arthritis
  • anti-TNF
  • health administrative data

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  • Contributors PB was involved in the design and acquisition; PB, FN and KM in the analysis; PB, MJB, LB, CT, FN and KM in the interpretation and FN and KM in the writing.

  • Funding This study was funded by Janssen, Canada funded this study. PB, KM, CT and FN are employees of Janssen, Canada. Study sponsors assisted with study design, interpretation of results and manuscript development.

  • Competing interests PB, CT, FN and KM are (were) employees of Janssen when the study was executed.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The raw data used for this study can be obtained by contacting the owner of the database (IMS Health Consulting). The analysis report used for this manuscript can be provided by communicating with FN.

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