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

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  • Cecilie Heegaard Brahe, University of Copenhagen
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  • Lykke Midtbøll Ørnbjerg, University of Copenhagen
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  • Lennart Jacobsson, University of Gothenburg
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  • Michael J. Nissen, University of Geneva
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  • Eirik Klami Kristianslund, Diakonhjemmet Hospital
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  • Herman Mann, Charles University
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  • Maria José Santos, University of Lisbon
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  • Juan Gómez Reino, Spanish Society of Rheumatology
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  • Dan Nordström, University of Helsinki
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  • Ziga Rotar, University of Ljubljana
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  • Bjorn Gudbjornsson, Landspitali University Hospital
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  • Fatos Onen, Dokuz Eylul University
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  • Catalin Codreanu, Carol Davila University of Medicine and Pharmacy
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  • Ulf Lindström, University of Gothenburg
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  • Burkhard Möller, University of Bern
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  • Tore K. Kvien, Diakonhjemmet Hospital
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  • Karel Pavelka, Charles University
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  • Anabela Barcelos, University of Aveiro
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  • Carlos Sánchez-Piedra, Spanish Society of Rheumatology
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  • Kari K. Eklund, University of Helsinki
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  • Matija Tomšič, University of Ljubljana
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  • Thorvardur Jon Love, University of Iceland
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  • Gercek Can, Dokuz Eylul University
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  • Ruxandra Ionescu, Carol Davila University of Medicine and Pharmacy
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  • Anne Gitte Loft
  • I. E. Van Der Horst-Bruinsma, University of Amsterdam, Vrije Universiteit Amsterdam
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  • Gary J. MacFarlane, University of Aberdeen
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  • Florenzo Iannone, University of Bari
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  • Lise Hejl Hyldstrup, University of Copenhagen
  • ,
  • Niels Steen Krogh, Zitelab
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  • Mikkel Østergaard, University of Copenhagen
  • ,
  • Merete Lund Hetland, University of Copenhagen

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 (United Kingdom)
Volume59
Issue7
Pages (from-to)1640-1650
Number of pages11
ISSN1462-0324
DOIs
Publication statusPublished - 2020

    Research areas

  • DAPSA28, DAS28, drug survival, effectiveness, epidemiology, psoriatic arthritis, register, response, spondyloarthritis, TNFi

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