TY - JOUR
T1 - Treatment response and drug retention rates in 24 195 biologic-naïve patients with axial spondyloarthritis initiating TNFi treatment
T2 - routine care data from 12 registries in the EuroSpA collaboration
AU - Ørnbjerg, Lykke Midtbøll
AU - Brahe, Cecilie Heegaard
AU - Askling, Johan
AU - Ciurea, Adrian
AU - Mann, Herman
AU - Onen, Fatos
AU - Kristianslund, Eirik Klami
AU - Nordström, Dan
AU - Santos, Maria Jose
AU - Codreanu, Catalin
AU - Gómez-Reino, Juan
AU - Rotar, Ziga
AU - Gudbjornsson, Bjorn
AU - Di Giuseppe, Daniela
AU - Nissen, Michael J.
AU - Pavelka, Karel
AU - Birlik, Merih
AU - Kvien, Tore
AU - Eklund, Kari Kalervo
AU - Barcelos, Anabela
AU - Ionescu, Ruxandra
AU - Sanchez-Piedra, Carlos
AU - Tomsic, Matija
AU - Geirsson, Árni Jón
AU - Loft, Anne Gitte
AU - Van Der Horst-Bruinsma, Irene
AU - Jones, Gareth
AU - Iannone, Florenzo
AU - Hyldstrup, Lise
AU - Krogh, Niels Steen
AU - Hetland, Merete Lund
AU - Østergaard, Mikkel
PY - 2019
Y1 - 2019
N2 - Objective To study drug retention and response rates in patients with axial spondyloarthritis (axSpA) initiating a first tumour necrosis factor inhibitor (TNFi). Methods Data from 12 European registries, prospectively collected in routine care, were pooled. TNFi retention rates (Kaplan-Meier statistics), Ankylosing Spondylitis Disease Activity Score (ASDAS) Inactive disease (<1.3), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) <40 mm and Assessment of SpondyloArthritis International Society responses (ASAS 20/40) were assessed at 6, 12 and 24 months. Results A first TNFi was initiated in 24 195 axSpA patients. Heterogeneity of baseline characteristics between registries was observed. Twelve-month retention was 80% (95% CI 79% to 80%), ranging from 71% to 94% across registries. At 6 months, ASDAS Inactive disease/BASDAI<40 rates were 33%/72% (LUNDEX-adjusted: 27%/59%), ASAS 20/40 response rates 64%/49% (LUNDEX-adjusted 52%/40%). In patients initiating first TNFi after 2009, 6097 patients was registered to fulfil ASAS criteria for axSpA, 2935 was registered to fulfil modified New York Criteria for Ankylosing Spondylitis and 1178 patients was registered as having non-radiographic axSpA. In nr-axSpA patients, we observed lower 12-month retention rates (73% (70%-76%)) and lower 6-month LUNDEX adjusted response rates (ASDAS Inactive disease/BASDAI40 20%/50%, ASAS 20/40 45%/33%). For patients initiating first TNFi after 2014, 12-month retention rate, but not 6-month response rate, was numerically higher compared with patients initiating TNFi in 2009-2014. Conclusion A large European database of patients with axSpA initiating a first TNFi treatment in routine care, demonstrated that 27% of patients achieved ASDAS inactive disease after 6 months, while 59% achieved BASDAI <40. Four of five patients continued treatment after 1 year.
AB - Objective To study drug retention and response rates in patients with axial spondyloarthritis (axSpA) initiating a first tumour necrosis factor inhibitor (TNFi). Methods Data from 12 European registries, prospectively collected in routine care, were pooled. TNFi retention rates (Kaplan-Meier statistics), Ankylosing Spondylitis Disease Activity Score (ASDAS) Inactive disease (<1.3), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) <40 mm and Assessment of SpondyloArthritis International Society responses (ASAS 20/40) were assessed at 6, 12 and 24 months. Results A first TNFi was initiated in 24 195 axSpA patients. Heterogeneity of baseline characteristics between registries was observed. Twelve-month retention was 80% (95% CI 79% to 80%), ranging from 71% to 94% across registries. At 6 months, ASDAS Inactive disease/BASDAI<40 rates were 33%/72% (LUNDEX-adjusted: 27%/59%), ASAS 20/40 response rates 64%/49% (LUNDEX-adjusted 52%/40%). In patients initiating first TNFi after 2009, 6097 patients was registered to fulfil ASAS criteria for axSpA, 2935 was registered to fulfil modified New York Criteria for Ankylosing Spondylitis and 1178 patients was registered as having non-radiographic axSpA. In nr-axSpA patients, we observed lower 12-month retention rates (73% (70%-76%)) and lower 6-month LUNDEX adjusted response rates (ASDAS Inactive disease/BASDAI40 20%/50%, ASAS 20/40 45%/33%). For patients initiating first TNFi after 2014, 12-month retention rate, but not 6-month response rate, was numerically higher compared with patients initiating TNFi in 2009-2014. Conclusion A large European database of patients with axSpA initiating a first TNFi treatment in routine care, demonstrated that 27% of patients achieved ASDAS inactive disease after 6 months, while 59% achieved BASDAI <40. Four of five patients continued treatment after 1 year.
KW - anti-TNF
KW - DMARDS (biologic)
KW - epidemiology
KW - outcomes research
KW - spondyloarthritis
U2 - 10.1136/annrheumdis-2019-215427
DO - 10.1136/annrheumdis-2019-215427
M3 - Journal article
C2 - 31431486
AN - SCOPUS:85071076531
SN - 0003-4967
VL - 78
SP - 1536
EP - 1544
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
IS - 11
ER -