Second and third TNF inhibitors in European patients with axial spondyloarthritis: Effectiveness and impact of the reason for switching

Louise Linde; Lykke Midtbøll Ørnbjerg; Cecilie Heegaard Brahe; Johan Karlsson Wallman; Daniela Di Giuseppe; Jakub Závada; Isabel Castrejon; Federico Díaz-Gonzalez; Ziga Rotar; Matija Tomšič; Bente Glintborg; Bjorn Gudbjornsson; Arni Jon Geirsson; Brigitte Michelsen; Eirik Klami Kristianslund; Maria José Santos; Anabela Barcelos; Dan Nordström; Kari K Eklund; Adrian Ciurea; Michael Nissen; Servet Akar; Lise Hejl Hyldstrup; Niels Steen Krogh; Merete Lund Hetland; Mikkel Østergaard

Second and third TNF inhibitors in European patients with axial spondyloarthritis: Effectiveness and impact of the reason for switching

Louise Linde^*, Lykke Midtbøll Ørnbjerg, Cecilie Heegaard Brahe, Johan Karlsson Wallman, Daniela Di Giuseppe, Jakub Závada, Isabel Castrejon, Federico Díaz-Gonzalez, Ziga Rotar, Matija Tomšič, Bente Glintborg, Bjorn Gudbjornsson, Arni Jon Geirsson, Brigitte Michelsen, Eirik Klami Kristianslund, Maria José Santos, Anabela Barcelos, Dan Nordström, Kari K Eklund, Adrian CiureaMichael Nissen, Servet Akar, Lise Hejl Hyldstrup, Niels Steen Krogh, Merete Lund Hetland, Mikkel Østergaard

^*Corresponding author for this work

Department for Rheumatology and Spine Diseases

Abstract

OBJECTIVE: To investigate real-world effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA) and the association with (i) treatment line (second and third TNFi-series) and (ii) reason for withdrawal from the preceding TNFi [lack of efficacy (LOE) vs adverse events (AE)].

METHODS: Prospectively collected routine care data from 12 European registries were pooled. Rates for 12-month drug retention and 6-month remission [Ankylosing Spondylitis Disease Activity Score C-reactive protein inactive disease (ASDAS-ID)] were assessed in second and third TNFi-series and stratified by withdrawal reason.

RESULTS: We included 8254 s and 2939 third TNFi-series; 12-month drug retention rates were similar (71%). Six-month ASDAS-ID rates were higher for the second (23%) than third TNFi (16%). Twelve-month drug retention rates for patients withdrawing from the preceding TNFi due to AE vs LOE were similar for the second (68% and 67%) and third TNFi (both 68%), while for the second TNFi, rates were lower in primary than secondary non-responders (LOE <26 vs ≥26 weeks) (58% vs 71%, P < 0.001). Six-month ASDAS-ID rates for the second TNFi were higher if the withdrawal reason was AE (27%) vs LOE (17%), P < 0.001, while similar for the third TNFi (19% vs 13%, P = 0.20).

CONCLUSION: A similar proportion of axSpA patients remained on a second and third TNFi after one year, but with low remission rates for the third TNFi. Remission rates on the second TNFi (but not the third) were higher if the withdrawal reason from the preceding TNFi was AE vs LOE.

Original language	English
Journal	Rheumatology (Oxford, England)
Volume	63
Issue number	7
Pages (from-to)	1882-1892
Number of pages	11
ISSN	1462-0324
Publication status	Published - 1 Jul 2024

Keywords

Adult
Antirheumatic Agents/therapeutic use
Axial Spondyloarthritis/drug therapy
Drug Substitution
Europe
Female
Humans
Male
Middle Aged
Prospective Studies
Registries
Remission Induction
Treatment Outcome
Tumor Necrosis Factor Inhibitors/therapeutic use
Tumor Necrosis Factor-alpha/antagonists & inhibitors
effectiveness
lack of efficacy
adverse events
axial spondyloarthritis
switching TNF-inhibitors

Cite this

Linde, L., Ørnbjerg, L. M., Brahe, C. H., Wallman, J. K., Di Giuseppe, D., Závada, J., Castrejon, I., Díaz-Gonzalez, F., Rotar, Z., Tomšič, M., Glintborg, B., Gudbjornsson, B., Geirsson, A. J., Michelsen, B., Kristianslund, E. K., Santos, M. J., Barcelos, A., Nordström, D., Eklund, K. K., ... Østergaard, M. (2024). Second and third TNF inhibitors in European patients with axial spondyloarthritis: Effectiveness and impact of the reason for switching. Rheumatology (Oxford, England), 63(7), 1882-1892.

Second and third TNF inhibitors in European patients with axial spondyloarthritis: Effectiveness and impact of the reason for switching. / Linde, Louise ; Ørnbjerg, Lykke Midtbøll ; Brahe, Cecilie Heegaard et al.
In: Rheumatology (Oxford, England), Vol. 63, No. 7, 01.07.2024, p. 1882-1892.

Research output: Contribution to journal › Journal article › Research › peer-review

Linde, L , Ørnbjerg, LM , Brahe, CH, Wallman, JK, Di Giuseppe, D, Závada, J, Castrejon, I, Díaz-Gonzalez, F, Rotar, Z, Tomšič, M, Glintborg, B, Gudbjornsson, B, Geirsson, AJ, Michelsen, B, Kristianslund, EK, Santos, MJ, Barcelos, A, Nordström, D, Eklund, KK, Ciurea, A, Nissen, M, Akar, S, Hyldstrup, LH, Krogh, NS, Hetland, ML & Østergaard, M 2024, 'Second and third TNF inhibitors in European patients with axial spondyloarthritis: Effectiveness and impact of the reason for switching', Rheumatology (Oxford, England), vol. 63, no. 7, pp. 1882-1892.

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title = "Second and third TNF inhibitors in European patients with axial spondyloarthritis: Effectiveness and impact of the reason for switching",

abstract = "OBJECTIVE: To investigate real-world effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA) and the association with (i) treatment line (second and third TNFi-series) and (ii) reason for withdrawal from the preceding TNFi [lack of efficacy (LOE) vs adverse events (AE)].METHODS: Prospectively collected routine care data from 12 European registries were pooled. Rates for 12-month drug retention and 6-month remission [Ankylosing Spondylitis Disease Activity Score C-reactive protein inactive disease (ASDAS-ID)] were assessed in second and third TNFi-series and stratified by withdrawal reason.RESULTS: We included 8254 s and 2939 third TNFi-series; 12-month drug retention rates were similar (71%). Six-month ASDAS-ID rates were higher for the second (23%) than third TNFi (16%). Twelve-month drug retention rates for patients withdrawing from the preceding TNFi due to AE vs LOE were similar for the second (68% and 67%) and third TNFi (both 68%), while for the second TNFi, rates were lower in primary than secondary non-responders (LOE <26 vs ≥26 weeks) (58% vs 71%, P < 0.001). Six-month ASDAS-ID rates for the second TNFi were higher if the withdrawal reason was AE (27%) vs LOE (17%), P < 0.001, while similar for the third TNFi (19% vs 13%, P = 0.20).CONCLUSION: A similar proportion of axSpA patients remained on a second and third TNFi after one year, but with low remission rates for the third TNFi. Remission rates on the second TNFi (but not the third) were higher if the withdrawal reason from the preceding TNFi was AE vs LOE.",

keywords = "Adult, Antirheumatic Agents/therapeutic use, Axial Spondyloarthritis/drug therapy, Drug Substitution, Europe, Female, Humans, Male, Middle Aged, Prospective Studies, Registries, Remission Induction, Treatment Outcome, Tumor Necrosis Factor Inhibitors/therapeutic use, Tumor Necrosis Factor-alpha/antagonists & inhibitors, effectiveness, lack of efficacy, adverse events, axial spondyloarthritis, switching TNF-inhibitors",

author = "Louise Linde and {\O}rnbjerg, {Lykke Midtb{\o}ll} and Brahe, {Cecilie Heegaard} and Wallman, {Johan Karlsson} and {Di Giuseppe}, Daniela and Jakub Z{\'a}vada and Isabel Castrejon and Federico D{\'i}az-Gonzalez and Ziga Rotar and Matija Tom{\v s}i{\v c} and Bente Glintborg and Bjorn Gudbjornsson and Geirsson, {Arni Jon} and Brigitte Michelsen and Kristianslund, {Eirik Klami} and Santos, {Maria Jos{\'e}} and Anabela Barcelos and Dan Nordstr{\"o}m and Eklund, {Kari K} and Adrian Ciurea and Michael Nissen and Servet Akar and Hyldstrup, {Lise Hejl} and Krogh, {Niels Steen} and Hetland, {Merete Lund} and Mikkel {\O}stergaard",

note = "COPECARE {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.",

year = "2024",

month = jul,

day = "1",

language = "English",

volume = "63",

pages = "1882--1892",

journal = "Rheumatology (Oxford, England)",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "7",

}

TY - JOUR

T1 - Second and third TNF inhibitors in European patients with axial spondyloarthritis

T2 - Effectiveness and impact of the reason for switching

AU - Linde, Louise

AU - Ørnbjerg, Lykke Midtbøll

AU - Brahe, Cecilie Heegaard

AU - Wallman, Johan Karlsson

AU - Di Giuseppe, Daniela

AU - Závada, Jakub

AU - Castrejon, Isabel

AU - Díaz-Gonzalez, Federico

AU - Rotar, Ziga

AU - Tomšič, Matija

AU - Glintborg, Bente

AU - Gudbjornsson, Bjorn

AU - Geirsson, Arni Jon

AU - Michelsen, Brigitte

AU - Kristianslund, Eirik Klami

AU - Santos, Maria José

AU - Barcelos, Anabela

AU - Nordström, Dan

AU - Eklund, Kari K

AU - Ciurea, Adrian

AU - Nissen, Michael

AU - Akar, Servet

AU - Hyldstrup, Lise Hejl

AU - Krogh, Niels Steen

AU - Hetland, Merete Lund

AU - Østergaard, Mikkel

N1 - COPECARE © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.

PY - 2024/7/1

Y1 - 2024/7/1

N2 - OBJECTIVE: To investigate real-world effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA) and the association with (i) treatment line (second and third TNFi-series) and (ii) reason for withdrawal from the preceding TNFi [lack of efficacy (LOE) vs adverse events (AE)].METHODS: Prospectively collected routine care data from 12 European registries were pooled. Rates for 12-month drug retention and 6-month remission [Ankylosing Spondylitis Disease Activity Score C-reactive protein inactive disease (ASDAS-ID)] were assessed in second and third TNFi-series and stratified by withdrawal reason.RESULTS: We included 8254 s and 2939 third TNFi-series; 12-month drug retention rates were similar (71%). Six-month ASDAS-ID rates were higher for the second (23%) than third TNFi (16%). Twelve-month drug retention rates for patients withdrawing from the preceding TNFi due to AE vs LOE were similar for the second (68% and 67%) and third TNFi (both 68%), while for the second TNFi, rates were lower in primary than secondary non-responders (LOE <26 vs ≥26 weeks) (58% vs 71%, P < 0.001). Six-month ASDAS-ID rates for the second TNFi were higher if the withdrawal reason was AE (27%) vs LOE (17%), P < 0.001, while similar for the third TNFi (19% vs 13%, P = 0.20).CONCLUSION: A similar proportion of axSpA patients remained on a second and third TNFi after one year, but with low remission rates for the third TNFi. Remission rates on the second TNFi (but not the third) were higher if the withdrawal reason from the preceding TNFi was AE vs LOE.

AB - OBJECTIVE: To investigate real-world effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA) and the association with (i) treatment line (second and third TNFi-series) and (ii) reason for withdrawal from the preceding TNFi [lack of efficacy (LOE) vs adverse events (AE)].METHODS: Prospectively collected routine care data from 12 European registries were pooled. Rates for 12-month drug retention and 6-month remission [Ankylosing Spondylitis Disease Activity Score C-reactive protein inactive disease (ASDAS-ID)] were assessed in second and third TNFi-series and stratified by withdrawal reason.RESULTS: We included 8254 s and 2939 third TNFi-series; 12-month drug retention rates were similar (71%). Six-month ASDAS-ID rates were higher for the second (23%) than third TNFi (16%). Twelve-month drug retention rates for patients withdrawing from the preceding TNFi due to AE vs LOE were similar for the second (68% and 67%) and third TNFi (both 68%), while for the second TNFi, rates were lower in primary than secondary non-responders (LOE <26 vs ≥26 weeks) (58% vs 71%, P < 0.001). Six-month ASDAS-ID rates for the second TNFi were higher if the withdrawal reason was AE (27%) vs LOE (17%), P < 0.001, while similar for the third TNFi (19% vs 13%, P = 0.20).CONCLUSION: A similar proportion of axSpA patients remained on a second and third TNFi after one year, but with low remission rates for the third TNFi. Remission rates on the second TNFi (but not the third) were higher if the withdrawal reason from the preceding TNFi was AE vs LOE.

KW - Adult

KW - Antirheumatic Agents/therapeutic use

KW - Axial Spondyloarthritis/drug therapy

KW - Drug Substitution

KW - Europe

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Registries

KW - Remission Induction

KW - Treatment Outcome

KW - Tumor Necrosis Factor Inhibitors/therapeutic use

KW - Tumor Necrosis Factor-alpha/antagonists & inhibitors

KW - effectiveness

KW - lack of efficacy

KW - adverse events

KW - axial spondyloarthritis

KW - switching TNF-inhibitors

UR - http://www.scopus.com/inward/record.url?scp=85197586238&partnerID=8YFLogxK

M3 - Journal article

C2 - 37738257

SN - 1462-0324

VL - 63

SP - 1882

EP - 1892

JO - Rheumatology (Oxford, England)

JF - Rheumatology (Oxford, England)

IS - 7

ER -

Second and third TNF inhibitors in European patients with axial spondyloarthritis: Effectiveness and impact of the reason for switching

Abstract

Keywords

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