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Gastrointestinal adverse drug reaction profile of etanercept: Real-world data from patients and healthcare professionals

  • Jette A. van Lint*
  • , Naomi T. Jessurun
  • , Sander W. Tas
  • , Bart J.F. van den Bemt
  • , Michael T. Nurmohamed
  • , Martijn B.A. van Doorn
  • , Phyllis I. Spuls
  • , Astrid M. van Tubergen
  • , Peter M. ten Klooster
  • , Eugene P. van Puijenbroek
  • , Frank Hoentjen
  • , Harald E. Vonkeman
  • *Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    Abstract

    Objective. We aimed to describe the nature and frequency of gastrointestinal adverse drug reactions (GI-ADRs) of etanercept (ETN) using patient-reported and healthcare professional (HCP)-registered data and compared this frequency with the GI-ADR frequency of the widely used tumor necrosis factor-α inhibitor adalimumab (ADA). Methods. Reported GI-ADRs of ETN for rheumatic diseases were collected from the Dutch Biologic Monitor and DREAM registries. We described the clinical course of GI-ADRs and compared the frequency with ADA in both data sources using Fisher exact test. Results. Out of 416 patients using ETN for inflammatory rheumatic diseases in the Dutch Biologic Monitor, 25 (6%) patients reported 36 GI-ADRs. In the DREAM registries 11 GI-ADRs were registered for 9 patients (2.3%), out of 399 patients using ETN, with an incidence of 7.1 per 1000 patient-years. Most GI-ADRs consisted of diarrhea, nausea, and abdominal pain. GI-ADRs led to ETN discontinuation in 1 patient (4%) and dose adjustment in 4 (16%) in the Dutch Biologic Monitor. Eight GI-ADRs (73%) led to ETN discontinuation in the DREAM registries. The frequency of GI-ADRs of ETN did not significantly differ from GI-ADRs of ADA in both data sources (Dutch Biologic Monitor: ETN 8.7% vs ADA 5.3%, P = 0.07; DREAM: ETN 2.8% vs ADA 4.7%, P = 0.16). Conclusion. Most GI-ADRs associated with ETN concerned gastrointestinal symptoms. These ADRs may lead to dose adjustment or ETN discontinuation. The frequency of ETN-associated GI-ADRs was comparable to the frequency of ADA-associated GI-ADRs. Knowledge about these previously unknown ADRs can facilitate early recognition and improve patient communication.

    Original languageEnglish
    Pages (from-to)1388-1394
    Number of pages7
    JournalJournal of rheumatology
    Volume48
    Issue number9
    Early online date1 Sept 2021
    DOIs
    Publication statusPublished - 1 Sept 2021

    Keywords

    • 2022 OA procedure
    • Biological therapy
    • Drug monitoring
    • Drug safety
    • Registries
    • Adverse drug reactions

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