Retention and response rates in 14261 PsA patients starting TNF inhibitor treatment-results from 12 countries in EuroSpA

Cecilie Heegaard Brahe, Lykke Midtbøll Ørnbjerg, Lennart Jacobsson, Michael J Nissen, Eirik Klami Kristianslund, Herman Mann, Maria José Santos, Juan Gómez Reino, Dan Nordström, Ziga Rotar, Bjorn Gudbjornsson, Fatos Onen, Catalin Codreanu, Ulf Lindström, Burkhard Möller, Tore K Kvien, Karel Pavelka, Anabela Barcelos, Carlos Sánchez-Piedra, Kari K EklundMatija Tomšič, Thorvardur Jon Love, Gercek Can, Ruxandra Ionescu, Anne Gitte Loft, I E van der Horst-Bruinsma, Gary J Macfarlane, Florenzo Iannone, Lise Hejl Hyldstrup, Niels Steen Krogh, Mikkel Østergaard, Merete Lund Hetland

29 Citations (Scopus)

Abstract

OBJECTIVE: To investigate TNF inhibitor (TNFi) retention and response rates in European biologic-naïve patients with PsA.

METHODS: Prospectively collected data on PsA patients in routine care from 12 European registries were pooled. Heterogeneity in baseline characteristics between registries were explored (analysis of variance and pairwise comparison). Retention rates (Kaplan-Meier), clinical remission [28-joint count DAS (DAS28) <2.6; 28 joint Disease Activity index for Psoriatic Arthritis ⩽4] and ACR criteria for 20% improvement (ACR20)/ACR50/ACR70 were calculated, including LUNDEX adjustment.

RESULTS: Overall, 14 261 patients with PsA initiated a first TNFi. Considerable heterogeneity of baseline characteristics between registries was observed. The median 12-month retention rate (95% CI) was 77% (76, 78%), ranging from 68 to 90% across registries. Overall, DAS28/28 joint Disease Activity index for Psoriatic Arthritis remission rates at 6 months were 56%/27% (LUNDEX: 45%/22%). Six-month ACR20/50/70 responses were 53%/38%/22%, respectively. In patients initiating a first TNFi after 2009 with registered fulfilment of ClASsification for Psoriatic ARthritis (CASPAR) criteria (n = 1980) or registered one or more swollen joint at baseline (n = 5803), the retention rates and response rates were similar to those found overall.

CONCLUSION: Approximately half of >14 000 patients with PsA who initiated first TNFi treatment in routine care were in DAS28 remission after 6 months, and three-quarters were still on the drug after 1 year. Considerable heterogeneity in baseline characteristics and outcomes across registries was observed. The feasibility of creating a large European database of PsA patients treated in routine care was demonstrated, offering unique opportunities for research with real-world data.

Original languageEnglish
JournalRheumatology (Oxford, England)
Volume59
Issue number7
Pages (from-to)1640-1650
Number of pages11
ISSN1462-0324
DOIs
Publication statusPublished - Jul 2020

Keywords

  • Adult
  • Antirheumatic Agents/therapeutic use
  • Arthritis, Psoriatic/drug therapy
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care
  • Prospective Studies
  • Registries
  • Treatment Outcome
  • Tumor Necrosis Factor Inhibitors/therapeutic use
  • effectiveness
  • DAS28
  • DAPSA28
  • epidemiology
  • spondyloarthritis
  • response
  • TNFi
  • psoriatic arthritis
  • drug survival
  • register

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