Predictors of treatment response and drug continuation in 842 patients with ankylosing spondylitis treated with anti-tumour necrosis factor: results from 8 years' surveillance in the Danish nationwide DANBIO registry

Abstract

TNFα inhibitors provide a rapid and sustained decrease of disease activity among patients with AS in clinical practice. Factors associated with continued treatment, clinical response and achievement of a BASDAI <40 mm were identified.

Real Life Experience of First Course of Anti-TNF Treatment in Ankylosing Spondylitis Patients in Brazil

“…In contrast, the Danish Registry found a non-significant association with gender [15]. Fibromyalgia affects 15% of AS patients in a male:female ratio of 1:3, and its symptoms of morning stiffness, fatigue and pain can lead to a confounding effect in the disease activity response, whereas the variables of anti-TNF drug and disease duration did not reach statistical significance [6,15].…”

“…Our findings showed an the BASDAI up to 6 months of therapy and that the BASDAI score fell from a median baseline value of 5.9 to a median value of 2.6 at 6 months, and then to 21 at 12 months. A clinical response was also observed for BASFI, Bath Ankylosing Spondylitis Metrology Index (BASMI), pain and fatigue and was sustained more than 5 years [15]. Other studies have evaluated the HRQoL using the Short Form 36…”

“…An Italian study found that male AS patients had higher chances of achieving a partial remission response after 12 months of anti-TNF therapy than female AS patients (OR 2.05, 95% CI 1.09-3.84), but that after 24 months the difference was not significant (OR 1.30, 95% CI 0.60-3.04) [19]. In contrast, the Danish Registry found a non-significant association with gender [15]. Fibromyalgia affects 15% of AS patients in a male:female ratio of 1:3, and its symptoms of morning stiffness, fatigue and pain can lead to a confounding effect in the disease activity response, whereas the variables of anti-TNF drug and disease duration did not reach statistical significance [6,15].…”

“…The BIOBADA BRASIL reported that one-third of AS patients discontinued therapy due to adverse effects [23], and Glintborg et al [15] reported a similar rate among Danish patients. Conversely, other studies have reported that adverse events were the major reason for drug discontinuation [24,25].…”

“…As patients were frequently assessed while they were waiting for their medication dispensing, the better organization may have resulted in fewer patients being willing to be interviewed. This potential for decrease in the number of patients being interviewed together with the commonly known reasons of therapy discontinuation, such as loss of efficacy and adverse events, could have contributed to the high withdraw rate observed at the 12-month follow-up [15,18]. Other studies have shown that the 1-year anti-TNF drug survival can range between 70% and 83% among AS patients [27,28].…”