Retention and response rates in 14 261 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 Eklund; Matija 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

doi:10.1093/rheumatology/kez427

Retention and response rates in 14 261 PsA patients starting TNF inhibitor treatment: results from 12 countries in EuroSpA

Cecilie Heegaard Brahe^* (Corresponding Author), 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

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

22 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 language	English
Pages (from-to)	1640-1650
Number of pages	11
Journal	Rheumatology
Volume	59
Issue number	7
Early online date	30 Oct 2019
DOIs	https://doi.org/10.1093/rheumatology/kez427
Publication status	Published - Jul 2020

Bibliographical note

Funding: This work was supported by Novartis. Novartis had no influence on the data collection, statistical analyses, manuscript preparation or decision to submit.

Keywords

psoriatic arthritis
spondyloarthritis
TNFi
effectiveness
drug survival
epidemiology
response
register
DAS28
DAPSA28
RHEUMATOID-ARTHRITIS
SURVIVAL
MODIFYING ANTIRHEUMATIC DRUGS
PREDICTORS THEREOF
PSORIATIC-ARTHRITIS
THERAPY
COMEDICATION
NECROSIS-FACTOR INHIBITORS
INFLIXIMAB
CLINICAL-PRACTICE

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Brahe, C. H., Ørnbjerg, L. M., Jacobsson, L., Nissen, M. J., Kristianslund, E. K., Mann, H., Santos, M. J., Reino, J. G., Nordström, D., Rotar, Z., Gudbjornsson, B., Onen, F., Codreanu, C., Lindström, U., Möller, B., Kvien, T. K., Pavelka, K., Barcelos, A., Sánchez-Piedra, C., ... Hetland, M. L. (2020). Retention and response rates in 14 261 PsA patients starting TNF inhibitor treatment: results from 12 countries in EuroSpA. Rheumatology, 59(7), 1640-1650. https://doi.org/10.1093/rheumatology/kez427

Brahe, CH, Ørnbjerg, LM, Jacobsson, L, Nissen, MJ, Kristianslund, EK, Mann, H, Santos, MJ, Reino, JG, Nordström, D, Rotar, Z, Gudbjornsson, B, Onen, F, Codreanu, C, Lindström, U, Möller, B, Kvien, TK, Pavelka, K, Barcelos, A, Sánchez-Piedra, C, Eklund, KK, Tomšič, M, Love, TJ, Can, G, Ionescu, R, Loft, AG, van der Horst-Bruinsma, IE, Macfarlane, GJ, Iannone, F, Hyldstrup, LH, Krogh, NS, Østergaard, M & Hetland, ML 2020, 'Retention and response rates in 14 261 PsA patients starting TNF inhibitor treatment: results from 12 countries in EuroSpA', Rheumatology, vol. 59, no. 7, pp. 1640-1650. https://doi.org/10.1093/rheumatology/kez427

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title = "Retention and response rates in 14 261 PsA patients starting TNF inhibitor treatment: results from 12 countries in EuroSpA",

abstract = "OBJECTIVE: To investigate TNF inhibitor (TNFi) retention and response rates in European biologic-na{\"i}ve 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.",

keywords = "psoriatic arthritis, spondyloarthritis, TNFi, effectiveness, drug survival, epidemiology, response, register, DAS28, DAPSA28, RHEUMATOID-ARTHRITIS, SURVIVAL, MODIFYING ANTIRHEUMATIC DRUGS, PREDICTORS THEREOF, PSORIATIC-ARTHRITIS, THERAPY, COMEDICATION, NECROSIS-FACTOR INHIBITORS, INFLIXIMAB, CLINICAL-PRACTICE",

author = "Brahe, {Cecilie Heegaard} and {\O}rnbjerg, {Lykke Midtb{\o}ll} and Lennart Jacobsson and Nissen, {Michael J} and Kristianslund, {Eirik Klami} and Herman Mann and Santos, {Maria Jos{\'e}} and Reino, {Juan G{\'o}mez} and Dan Nordstr{\"o}m and Ziga Rotar and Bjorn Gudbjornsson and Fatos Onen and Catalin Codreanu and Ulf Lindstr{\"o}m and Burkhard M{\"o}ller and Kvien, {Tore K} and Karel Pavelka and Anabela Barcelos and Carlos S{\'a}nchez-Piedra and Eklund, {Kari K} and Matija Tom{\v s}i{\v c} and Love, {Thorvardur Jon} and Gercek Can and Ruxandra Ionescu and Loft, {Anne Gitte} and {van der Horst-Bruinsma}, {I E} and Macfarlane, {Gary J} and Florenzo Iannone and Hyldstrup, {Lise Hejl} and Krogh, {Niels Steen} and Mikkel {\O}stergaard and Hetland, {Merete Lund}",

note = "Funding: This work was supported by Novartis. Novartis had no influence on the data collection, statistical analyses, manuscript preparation or decision to submit. ",

year = "2020",

month = jul,

doi = "10.1093/rheumatology/kez427",

language = "English",

volume = "59",

pages = "1640--1650",

journal = "Rheumatology",

issn = "1462-0324",

publisher = "OXFORD UNIV PRESS INC",

number = "7",

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TY - JOUR

T1 - Retention and response rates in 14 261 PsA patients starting TNF inhibitor treatment

T2 - results from 12 countries in EuroSpA

AU - Brahe, Cecilie Heegaard

AU - Ørnbjerg, Lykke Midtbøll

AU - Jacobsson, Lennart

AU - Nissen, Michael J

AU - Kristianslund, Eirik Klami

AU - Mann, Herman

AU - Santos, Maria José

AU - Reino, Juan Gómez

AU - Nordström, Dan

AU - Rotar, Ziga

AU - Gudbjornsson, Bjorn

AU - Onen, Fatos

AU - Codreanu, Catalin

AU - Lindström, Ulf

AU - Möller, Burkhard

AU - Kvien, Tore K

AU - Pavelka, Karel

AU - Barcelos, Anabela

AU - Sánchez-Piedra, Carlos

AU - Eklund, Kari K

AU - Tomšič, Matija

AU - Love, Thorvardur Jon

AU - Can, Gercek

AU - Ionescu, Ruxandra

AU - Loft, Anne Gitte

AU - van der Horst-Bruinsma, I E

AU - Macfarlane, Gary J

AU - Iannone, Florenzo

AU - Hyldstrup, Lise Hejl

AU - Krogh, Niels Steen

AU - Østergaard, Mikkel

AU - Hetland, Merete Lund

N1 - Funding: This work was supported by Novartis. Novartis had no influence on the data collection, statistical analyses, manuscript preparation or decision to submit.

PY - 2020/7

Y1 - 2020/7

N2 - 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.

AB - 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.

KW - psoriatic arthritis

KW - spondyloarthritis

KW - TNFi

KW - effectiveness

KW - drug survival

KW - epidemiology

KW - response

KW - register

KW - DAS28

KW - DAPSA28

KW - RHEUMATOID-ARTHRITIS

KW - SURVIVAL

KW - MODIFYING ANTIRHEUMATIC DRUGS

KW - PREDICTORS THEREOF

KW - PSORIATIC-ARTHRITIS

KW - THERAPY

KW - COMEDICATION

KW - NECROSIS-FACTOR INHIBITORS

KW - INFLIXIMAB

KW - CLINICAL-PRACTICE

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U2 - 10.1093/rheumatology/kez427

DO - 10.1093/rheumatology/kez427

M3 - Article

C2 - 31665497

SN - 1462-0324

VL - 59

SP - 1640

EP - 1650

JO - Rheumatology

JF - Rheumatology

IS - 7

ER -

Retention and response rates in 14 261 PsA patients starting TNF inhibitor treatment: results from 12 countries in EuroSpA

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Bibliographical note

Keywords

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