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Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration

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Harvard

Lindström, U, Di Giuseppe, D, Delcoigne, B, Glintborg, B, Möller, B, Ciurea, A, Pombo-Suarez, M, Sanchez-Piedra, C, Eklund, K, Relas, H, Gudbjornsson, B, Love, TJ, Jones, GT, Codreanu, C, Ionescu, R, Nekvindova, L, Závada, J, Atas, N, Yolbas, S, Fagerli, KM, Michelsen, B, Rotar, Ž, Tomšič, M, Iannone, F, Santos, MJ, Avila-Ribeiro, P, Ørnbjerg, LM, Østergaard, M, Jacobsson, LT, Askling, J & Nissen, MJ 2021, 'Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration', Annals of the Rheumatic Diseases, bind 80, nr. 11, s. 1410-1418. https://doi.org/10.1136/annrheumdis-2021-220097

APA

Lindström, U., Di Giuseppe, D., Delcoigne, B., Glintborg, B., Möller, B., Ciurea, A., Pombo-Suarez, M., Sanchez-Piedra, C., Eklund, K., Relas, H., Gudbjornsson, B., Love, T. J., Jones, G. T., Codreanu, C., Ionescu, R., Nekvindova, L., Závada, J., Atas, N., Yolbas, S., ... Nissen, M. J. (2021). Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration. Annals of the Rheumatic Diseases, 80(11), 1410-1418. https://doi.org/10.1136/annrheumdis-2021-220097

CBE

Lindström U, Di Giuseppe D, Delcoigne B, Glintborg B, Möller B, Ciurea A, Pombo-Suarez M, Sanchez-Piedra C, Eklund K, Relas H, Gudbjornsson B, Love TJ, Jones GT, Codreanu C, Ionescu R, Nekvindova L, Závada J, Atas N, Yolbas S, Fagerli KM, Michelsen B, Rotar Ž, Tomšič M, Iannone F, Santos MJ, Avila-Ribeiro P, Ørnbjerg LM, Østergaard M, Jacobsson LT, Askling J, Nissen MJ. 2021. Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration. Annals of the Rheumatic Diseases. 80(11):1410-1418. https://doi.org/10.1136/annrheumdis-2021-220097

MLA

Vancouver

Author

Lindström, Ulf ; Di Giuseppe, Daniela ; Delcoigne, Bénédicte ; Glintborg, Bente ; Möller, Burkhard ; Ciurea, Adrian ; Pombo-Suarez, Manuel ; Sanchez-Piedra, Carlos ; Eklund, Kari ; Relas, Heikki ; Gudbjornsson, Bjorn ; Love, Thorvardur Jon ; Jones, Gareth T ; Codreanu, Catalin ; Ionescu, Ruxandra ; Nekvindova, Lucie ; Závada, Jakub ; Atas, Nuh ; Yolbas, Servet ; Fagerli, Karen Minde ; Michelsen, Brigitte ; Rotar, Žiga ; Tomšič, Matija ; Iannone, Florenzo ; Santos, Maria Jose ; Avila-Ribeiro, Pedro ; Ørnbjerg, Lykke Midtbøll ; Østergaard, Mikkel ; Jacobsson, Lennart Th ; Askling, Johan ; Nissen, Michael J. / Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration. I: Annals of the Rheumatic Diseases. 2021 ; Bind 80, Nr. 11. s. 1410-1418.

Bibtex

@article{b8c34b543af24c08be7a19f63998aa89,
title = "Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration",
abstract = "BACKGROUND: Comedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) during treatment with tumour necrosis factor inhibitors (TNFi) is extensively used in psoriatic arthritis (PsA), although the additive benefit remains unclear. We aimed to compare treatment outcomes in patients with PsA treated with TNFi and csDMARD comedication versus TNFi monotherapy.METHODS: Patients with PsA from 13 European countries who initiated a first TNFi in 2006-2017 were included. Country-specific comparisons of 1 year TNFi retention were performed by csDMARD comedication status, together with HRs for TNFi discontinuation (comedication vs monotherapy), adjusted for age, sex, calendar year, disease duration and Disease Activity Score with 28 joints (DAS28). Adjusted ORs of clinical remission (based on DAS28) at 12 months were calculated. Between-country heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not significant. Secondary analyses stratified according to TNFi subtype (adalimumab/infliximab/etanercept) and restricted to methotrexate as comedication were performed.RESULTS: In total, 15 332 patients were included (62% comedication, 38% monotherapy). TNFi retention varied across countries, with significant heterogeneity precluding a combined estimate. Comedication was associated with better remission rates, pooled OR 1.25 (1.12-1.41). Methotrexate comedication was associated with improved remission for adalimumab (OR 1.45 (1.23-1.72)) and infliximab (OR 1.55 (1.21-1.98)) and improved retention for infliximab. No effect of comedication was demonstrated for etanercept.CONCLUSION: This large observational study suggests that, as used in clinical practice, csDMARD and TNFi comedication are associated with improved remission rates, and specifically, comedication with methotrexate increases remission rates for both adalimumab and infliximab.",
keywords = "Adalimumab/therapeutic use, Adult, Antirheumatic Agents/therapeutic use, Arthritis, Psoriatic/drug therapy, Drug Therapy, Combination, Etanercept/therapeutic use, Female, Humans, Infliximab/therapeutic use, Male, Methotrexate/therapeutic use, Middle Aged, Remission Induction, Treatment Outcome, Tumor Necrosis Factor Inhibitors/therapeutic use",
author = "Ulf Lindstr{\"o}m and {Di Giuseppe}, Daniela and B{\'e}n{\'e}dicte Delcoigne and Bente Glintborg and Burkhard M{\"o}ller and Adrian Ciurea and Manuel Pombo-Suarez and Carlos Sanchez-Piedra and Kari Eklund and Heikki Relas and Bjorn Gudbjornsson and Love, {Thorvardur Jon} and Jones, {Gareth T} and Catalin Codreanu and Ruxandra Ionescu and Lucie Nekvindova and Jakub Z{\'a}vada and Nuh Atas and Servet Yolbas and Fagerli, {Karen Minde} and Brigitte Michelsen and {\v Z}iga Rotar and Matija Tom{\v s}i{\v c} and Florenzo Iannone and Santos, {Maria Jose} and Pedro Avila-Ribeiro and {\O}rnbjerg, {Lykke Midtb{\o}ll} and Mikkel {\O}stergaard and Jacobsson, {Lennart Th} and Johan Askling and Nissen, {Michael J}",
note = "{\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. COPECARE",
year = "2021",
month = nov,
doi = "10.1136/annrheumdis-2021-220097",
language = "English",
volume = "80",
pages = "1410--1418",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "B M J Group",
number = "11",

}

RIS

TY - JOUR

T1 - Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration

AU - Lindström, Ulf

AU - Di Giuseppe, Daniela

AU - Delcoigne, Bénédicte

AU - Glintborg, Bente

AU - Möller, Burkhard

AU - Ciurea, Adrian

AU - Pombo-Suarez, Manuel

AU - Sanchez-Piedra, Carlos

AU - Eklund, Kari

AU - Relas, Heikki

AU - Gudbjornsson, Bjorn

AU - Love, Thorvardur Jon

AU - Jones, Gareth T

AU - Codreanu, Catalin

AU - Ionescu, Ruxandra

AU - Nekvindova, Lucie

AU - Závada, Jakub

AU - Atas, Nuh

AU - Yolbas, Servet

AU - Fagerli, Karen Minde

AU - Michelsen, Brigitte

AU - Rotar, Žiga

AU - Tomšič, Matija

AU - Iannone, Florenzo

AU - Santos, Maria Jose

AU - Avila-Ribeiro, Pedro

AU - Ørnbjerg, Lykke Midtbøll

AU - Østergaard, Mikkel

AU - Jacobsson, Lennart Th

AU - Askling, Johan

AU - Nissen, Michael J

N1 - © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. COPECARE

PY - 2021/11

Y1 - 2021/11

N2 - BACKGROUND: Comedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) during treatment with tumour necrosis factor inhibitors (TNFi) is extensively used in psoriatic arthritis (PsA), although the additive benefit remains unclear. We aimed to compare treatment outcomes in patients with PsA treated with TNFi and csDMARD comedication versus TNFi monotherapy.METHODS: Patients with PsA from 13 European countries who initiated a first TNFi in 2006-2017 were included. Country-specific comparisons of 1 year TNFi retention were performed by csDMARD comedication status, together with HRs for TNFi discontinuation (comedication vs monotherapy), adjusted for age, sex, calendar year, disease duration and Disease Activity Score with 28 joints (DAS28). Adjusted ORs of clinical remission (based on DAS28) at 12 months were calculated. Between-country heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not significant. Secondary analyses stratified according to TNFi subtype (adalimumab/infliximab/etanercept) and restricted to methotrexate as comedication were performed.RESULTS: In total, 15 332 patients were included (62% comedication, 38% monotherapy). TNFi retention varied across countries, with significant heterogeneity precluding a combined estimate. Comedication was associated with better remission rates, pooled OR 1.25 (1.12-1.41). Methotrexate comedication was associated with improved remission for adalimumab (OR 1.45 (1.23-1.72)) and infliximab (OR 1.55 (1.21-1.98)) and improved retention for infliximab. No effect of comedication was demonstrated for etanercept.CONCLUSION: This large observational study suggests that, as used in clinical practice, csDMARD and TNFi comedication are associated with improved remission rates, and specifically, comedication with methotrexate increases remission rates for both adalimumab and infliximab.

AB - BACKGROUND: Comedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) during treatment with tumour necrosis factor inhibitors (TNFi) is extensively used in psoriatic arthritis (PsA), although the additive benefit remains unclear. We aimed to compare treatment outcomes in patients with PsA treated with TNFi and csDMARD comedication versus TNFi monotherapy.METHODS: Patients with PsA from 13 European countries who initiated a first TNFi in 2006-2017 were included. Country-specific comparisons of 1 year TNFi retention were performed by csDMARD comedication status, together with HRs for TNFi discontinuation (comedication vs monotherapy), adjusted for age, sex, calendar year, disease duration and Disease Activity Score with 28 joints (DAS28). Adjusted ORs of clinical remission (based on DAS28) at 12 months were calculated. Between-country heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not significant. Secondary analyses stratified according to TNFi subtype (adalimumab/infliximab/etanercept) and restricted to methotrexate as comedication were performed.RESULTS: In total, 15 332 patients were included (62% comedication, 38% monotherapy). TNFi retention varied across countries, with significant heterogeneity precluding a combined estimate. Comedication was associated with better remission rates, pooled OR 1.25 (1.12-1.41). Methotrexate comedication was associated with improved remission for adalimumab (OR 1.45 (1.23-1.72)) and infliximab (OR 1.55 (1.21-1.98)) and improved retention for infliximab. No effect of comedication was demonstrated for etanercept.CONCLUSION: This large observational study suggests that, as used in clinical practice, csDMARD and TNFi comedication are associated with improved remission rates, and specifically, comedication with methotrexate increases remission rates for both adalimumab and infliximab.

KW - Adalimumab/therapeutic use

KW - Adult

KW - Antirheumatic Agents/therapeutic use

KW - Arthritis, Psoriatic/drug therapy

KW - Drug Therapy, Combination

KW - Etanercept/therapeutic use

KW - Female

KW - Humans

KW - Infliximab/therapeutic use

KW - Male

KW - Methotrexate/therapeutic use

KW - Middle Aged

KW - Remission Induction

KW - Treatment Outcome

KW - Tumor Necrosis Factor Inhibitors/therapeutic use

UR - http://www.scopus.com/inward/record.url?scp=85107521561&partnerID=8YFLogxK

U2 - 10.1136/annrheumdis-2021-220097

DO - 10.1136/annrheumdis-2021-220097

M3 - Journal article

C2 - 34083206

VL - 80

SP - 1410

EP - 1418

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 11

ER -

ID: 70407523