The aim  of this study was to evaluate and to compare drug retention between the 3 anti-TNF marketed in Tunisia.
Methods: We achieved a retrospective descriptive and comparative monocentric study, on 26 patients, with spondyloarthritis (SpA) including psoriatic arthritis (psA), enteropathic arthritis (EA), reactive arthritis (ReA) and undifferentiated spondyloarthritis (USpA) (according to ASAS 2009 and CASPAR), during 12 years (2004-2015). The patients were treated with at least one anti-TNF, during at least 6 months. All patients with EA were treated by anti-TNF monoclonal antibodies. Drug survival was analysed by means of Kaplan–Meier curves
Results:  Mean age was 45,7 (±10,77) years. Seventeen patients were male. The mean disease duration was 10,16 (±8,88) years. Thirteen patients (27%) had a psA and 11 patients (22%) had EA. One patient had an USpA, and 1 patient had a ReA. Twelve patients received infliximab (IFX), 7 etanercept and 7 adalimumab. The median duration of prescription of anti-TNF therapy was 3,24 years [0.5-8] with 1-year and 2-year drug survival rates of 70% and 60%, respectively. No statistically significant difference in terms of survival was observed between the three anti-TNF drugs (p=0,23). The reasons for discontinuing treatment were distributed as follows: lack of efficacy in 3 cases, adverse event in 4 cases. One case of death occurred in a patient with ReA treated with IFX. The death was due to gastrointestinal bleeding with indomethacin. This incident had no direct or indirect relationship with IFX.
Conclusion: This study demonstrated that anti-TNF showed a satisfactory and comparable drug survival in SpA treatment.

Drug survival of anti tumor necrosis factor α in patients with spondyloarthritis: The Tunisian experience