Effect of Comedication With Conventional Synthetic Disease‐Modifying Antirheumatic Drugs on Retention of Tumor Necrosis Factor Inhibitors in Patients With Spondyloarthritis: A Prospective Cohort Study

Sepriano, Alexandre; Ramiro, Sofía; Heijde, Desirée van der; Ávila-Ribeiro, Pedro; Fonseca, R.; Borges, Joana; Teixeira, L.; Carvalho, P.; Cerqueira, Marcos; Neves, Joana Sousa; Meirinhos, T.; Barcelos, Anabela; Sequeira, Graça; Salvador, Maria João; Silva, J. Canas da; Santos, Helena; Bernardes, Miguel; Vieira-Sousa, Elsa; Canhão, Helena; Branco, Jaime; Pimentel-Santos, Fernando; Landewé, Robert

doi:10.1002/art.39772

Cited by 26 publications

(20 citation statements)

References 23 publications

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“…Concerning the effect of csDMARD, the only study for patients with SpA (excluding PsA) from the Rheumatic Diseases Portuguese Register reported no protective effect 16 . Because the effect of csDMARD is dependent on both the disease and individual TNFi agent, differences in these variables among different cohorts may explain observed discrepancies.…”

Section: Rheumatologymentioning

confidence: 99%

“…However, other response indices (ASDAS-ID, DAS28-inactive state, and ACR70) were not found to be associated with BMI (data not shown). Regarding smoking, conflicting available data exist in the literature, supporting either a negative effect or no role in drug survival 16,27 . In our cohort, both in univariate and multivariable regression analyses of available data (n = 234, 55% current, 12% past smokers, 33% never smoked), smoking status (treated either as ever/never or as non/past/current smoking) was not a significant predictor for TNFi survival overall (data not shown).…”

Section: Rheumatologymentioning

confidence: 99%

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Comparative Analysis and Predictors of 10-year Tumor Necrosis Factor Inhibitors Drug Survival in Patients with Spondyloarthritis: First-year Response Predicts Longterm Drug Persistence

Flouri

Markatseli²,

Boki³

et al. 2018

J Rheumatol

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Objective.To evaluate the 10-year drug survival of the first tumor necrosis factor inhibitor (TNFi) administered to patients with spondyloarthritis (SpA) overall and comparatively between SpA subsets, and to identify predictors of drug retention.Methods.Patients with SpA in the Hellenic Registry of Biologic Therapies, a prospective multicenter observational cohort, starting their first TNFi between 2004–2014 were analyzed. Kaplan-Meier curves and Cox regression models were used.Results.Overall, 404 out of 1077 patients (37.5%) discontinued treatment (followup: 4288 patient-yrs). Ten-year drug survival was 49%. In the unadjusted analyses, higher TNFi survival was observed in patients with ankylosing spondylitis (AS) compared to undifferentiated SpA and psoriatic arthritis [PsA; significant beyond the first 2.5 (p = 0.003) years and 7 years (p < 0.001), respectively], and in patients treated for isolated axial versus peripheral arthritis (p = 0.001). In all multivariable analyses, male sex was a predictor for longer TNFi survival. Use of methotrexate (MTX) was a predictor in PsA and in patients with peripheral arthritis. Absence of peripheral arthritis and use of a monoclonal antibody (as opposed to non-antibody TNFi) independently predicted longer TNFi survival in axial disease because of lower rates of inefficacy. Achievement of major responses during the first year in either axial or peripheral arthritis was the strongest predictor of longer therapy retention (HR 0.33, 95% CI 0.26–0.41 for Ankylosing Spondylitis Disease Activity Score inactive disease, and HR 0.35, 95% CI 0.24–0.50 for 28-joint Disease Activity Score remission).Conclusion.The longterm retention of the first TNFi administered to patients with SpA is high, especially for males with axial disease. The strongest predictor of longterm TNFi survival is a major response within the first year of treatment.

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Section: Rheumatologymentioning

confidence: 99%

Section: Rheumatologymentioning

confidence: 99%

Comparative Analysis and Predictors of 10-year Tumor Necrosis Factor Inhibitors Drug Survival in Patients with Spondyloarthritis: First-year Response Predicts Longterm Drug Persistence

Flouri

Markatseli²,

Boki³

et al. 2018

J Rheumatol

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“…Of the 70 included studies, 19 were full-text articles, 7,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] while 51 were conference abstracts. Study characteristics are described in Supplementary Table 6.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…28 studies were performed in patients with IA; 18,19,26-28,30-36,47,49-51,55-57, 59-63,67,79,80,83 25 in patients with RA; 7,16,17,23,24,37,39,40,[42][43][44][45]53,54,58,66,68,70,[73][74][75][76][77][78]84 5 in patients with AS; 21,25,46,48,65 4 in patients with PsA; 41,64,71,81 4 in patients with UC; 22,69,72,82 2 in patients with IBD (with results reported separately for UC); 38,52 and one in patients with SpA. 29 Most studies were retrospective (n=37), while 28 were prospective and one was cross-sectional. Four studies did not report the study design.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Among the studies including patients with IA, 21 studies included some form of PRO, 18,20,21,23,24,27,[29][30][31]36,48,49,54,57,59,65,75,77,78,80,84 of which 10 studies reported PROs prior to the switch only and therefore did not provide any information on the patient experience of switching treatment. 20,21,23,24,[29][30][31]49,59,78 The PRO measurement tools used are summarized in Figure 3.…”

Section: Indirectly Reported Patient Experience Of Switchingmentioning

confidence: 99%

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<p>Real-World Patient Experience of Switching Biologic Treatment in Inflammatory Arthritis and Ulcerative Colitis – A Systematic Literature Review</p>

Luttropp¹,

Dalén²,

Svedbom³

et al. 2020

PPA

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Purpose: To obtain an up-to-date overview of the measurement of patient experience of switching biologic treatment in patients with inflammatory arthritis (IA) or ulcerative colitis (UC). Secondary objectives included summarizing the types of patient-reported outcomes (PROs) used (if any), and related findings; and summarizing medical and non-medical reasons for treatment switch and/or discontinuation. Methods: A systematic literature review (SLR) was performed, searching Medline and Embase for relevant publications. Results: In total, 70 relevant publications were identified. While the majority of these reported reasons for switching and/or discontinuing treatment, only four provided information explicitly regarding patient-reported experience of switching biologic treatment. All four utilized ranking tools to assess patient experience of switching biologic treatment. The most common reason for switching and/or discontinuing treatment was loss of efficacy, while the least common reason was patient preference. Conclusion: Although the number of available treatments in IA and UC have increased, there is a sparsity of information regarding patient-reported experience of switching biologic treatment. Further research regarding patient preference and/or experience would benefit this therapeutic area and help guide treatment choices.

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Distinct long-term disease activity trajectories differentiate early on treatment with etanercept in both rheumatoid arthritis and spondylarthritis patients: a prospective cohort study

Flouri,

Goutakoli,

Repa

et al. 2023

Rheumatol Int

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To characterize disease activity trajectories and compare long-term drug retention between rheumatoid (RA) and spondylarthritis (SpA) patients initiating tumor necrosis factor inhibitor (TNFi) treatment (etanercept). Prospective observational study of RA, axial (AxSpA) and peripheral SpA (PerSpA) patients initiating etanercept during 2004–2020. Kaplan–Meier plots were used for drug retention comparisons and multivariable Cox regression models for predictors of discontinuation. Long-term disease activity trajectories were identified by latent class growth models using DAS28-ESR or ASDAS-CRP as outcome for RA and AxSpA respectively. We assessed 711 patients (450 RA, 178 AxSpA and 83 PerSpA) with a median (IQR) follow-up of 12 (5–32) months. At 5 years, 22%, 30% and 21% of RA, AxSpA and PerSpA patients, respectively, remained on therapy. Etanercept discontinuation was independent of the diagnosis and was predicted by gender and obesity in both RA and SpA groups. Four disease activity (DA) trajectories were identified from 6th month of treatment in both RA and AxSpA. RA patients in remission-low DA groups (33.7%) were younger, had shorter disease duration, fewer comorbidities and lower baseline disease activity compared to moderate (40.6%) & high DA (25.7%) groups. In AxSpA 74% were in inactive-low DA and they were more often males, non-obese and had lower number of comorbidities compared to higher ASDAS-CRP trajectories. In RA and AxSpA patients, disease activity trajectories revealed heterogeneity of TNFi treatment responses and prognosis. Male gender, lower baseline disease activity and fewer comorbidities, characterize a favourable outcome in terms of disease burden accrual and TNFi survival.

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Effect of Comedication With Conventional Synthetic Disease‐Modifying Antirheumatic Drugs on Retention of Tumor Necrosis Factor Inhibitors in Patients With Spondyloarthritis: A Prospective Cohort Study

Abstract: Comedication with csDMARDs does not prolong TNFi retention in patients with SpA in clinical practice, suggesting that there is no benefit conferred by the concomitant use of these drugs.

Cited by 26 publications

References 23 publications

Comparative Analysis and Predictors of 10-year Tumor Necrosis Factor Inhibitors Drug Survival in Patients with Spondyloarthritis: First-year Response Predicts Longterm Drug Persistence

Comparative Analysis and Predictors of 10-year Tumor Necrosis Factor Inhibitors Drug Survival in Patients with Spondyloarthritis: First-year Response Predicts Longterm Drug Persistence

<p>Real-World Patient Experience of Switching Biologic Treatment in Inflammatory Arthritis and Ulcerative Colitis – A Systematic Literature Review</p>

Distinct long-term disease activity trajectories differentiate early on treatment with etanercept in both rheumatoid arthritis and spondylarthritis patients: a prospective cohort study

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