Drug effectiveness of 2nd and 3rd TNF inhibitors in psoriatic arthritis – relationship with the reason for withdrawal from the previous treatment - 11/07/24
, Cecilie Heegaard Brahe a, 1, Louise Linde a, Lennart Jacobsson c, Michael J. Nissen d, Eirik Klami Kristianslund e, Maria José Santos f, Dan Nordström g, Ziga Rotar h, Bjorn Gudbjornsson i, Fatos Onen j, Catalin Codreanu k, Ulf Lindström c, Burkhard Möller l, Tore K. Kvien e, Anabela Barcelos m, Kari K. Eklund n, Matija Tomšič h, Thorvardur Jon Love o, Gercek Can j, Ruxandra Ionescu k, Anne Gitte Loft b, p, Herman Mann q, Karel Pavelka q, Marleen van de Sande r, s, I.E. van der Horst-Bruinsma t, Manuel Pombo Suarez u, Carlos Sánchez-Piedra v, Gary J. Macfarlane w, Florenzo Iannone x, Brigitte Michelsen a, d, y, Lise Hejl Hyldstrup a, Niels Steen Krogh z, Mikkel Østergaard a, aa, 2, Merete Lund Hetland a, aa, 2Highlights |
• | Effectiveness of a 2nd and 3rd TNFi treatment in PsA patients was lower than what has previously been reported for the 1st TNFi treatment. |
• | Initiation of a 2nd or 3rd TNFi treatment in clinical practice led to DAS28 remission in a substantial number of PsA patients. |
• | Similar drug effectiveness was observed in patients who stopped the previous TNFi due to AE compared to overall LOE, while better drug effectiveness was found in patients who had stopped the previous TNF due to secondary LOE compared to primary LOE. |
Abstract |
Objective |
To investigate real-world retention and remission rates in PsA patients initiating a 2nd or 3rd TNFi and the association with reason for discontinuation from the previous TNFi-treatment.
Methods |
Prospectively collected routine care data from 12 European registries were pooled. Retention rates (Kaplan-Meier estimation) and crude/LUNDEX-adjusted rates of Disease Activity Score 28 and Disease Activity index for PSoriatic Arthritis (DAS28 and DAPSA28) remission were calculated and compared with adjusted Cox regression analyses and Chi-squared test, respectively).
Results |
We included 5233 (2nd TNFi) and 1906 (3rd TNFi) patients. Twelve-month retention rates for the 2nd and 3rd TNFi were 68% (95%CI: 67–70%) and 66% (64–68%), respectively. Patients who stopped the previous TNFi due to AE/LOE had 12-month retention rates of 66%/65% (2nd TNFi), and 65%/63% (3rd TNFi), respectively. Patients who stopped the previous TNFi due to LOE after less vs more than 24 weeks had 12-month retention rates of 54%/69% (2nd TNFi), and 58%/65% (3rd TNFi). Six-month crude/LUNDEX-adjusted DAS28 remission rates were 48%/35% and 38%/27%, and DAPSA28 remission rates were 19%/14% and 14%/10%, for the 2nd and 3rd TNFi.
Conclusion |
Two-thirds of patients remained on TNFi at 12months for both the 2nd and 3rd TNFi, while one-third and one-quarter of patients were in DAS28 remission after 6months on the 2nd and 3rd TNFi. While drug effectiveness was similar in patients who stopped the previous TNFi due to AE compared to overall LOE, drug effectiveness was better in patients who had stopped the previous TNF due to secondary LOE compared to primary LOE.
Le texte complet de cet article est disponible en PDF.Keywords : Psoriatic arthritis, TNF-inhibitors, Epidemiology, Treatment withdrawal
Plan
Vol 91 - N° 4
Article 105729- juillet 2024 Retour au numéro
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