Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice: results from the nationwide Danish DANBIO registry

Lykke Midtbøll Ørnbjerg; Mikkel Østergaard; Pernille Bøyesen; Niels Steen Krogh; Anja Thormann; Ulrik Tarp; Uta Engling Poulsen; Jakob Espesen; Vibeke Stevenius Ringsdal; Niels Graudal; Gina Birgitte Kollerup; Dorte Vendelbo Jensen; Ole Rintek Madsen; Bente Glintborg; Torben Steen Christensen; Hanne Lindegaard; Ditte Dencker; Annette Hansen; Anne Rødgaard Andersen; Merete Lund Hetland

doi:10.1136/annrheumdis-2012-201319

Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice: results from the nationwide Danish DANBIO registry

Lykke Midtbøll Ørnbjerg, Mikkel Østergaard, Pernille Bøyesen, Niels Steen Krogh, Anja Thormann, Ulrik Tarp, Uta Engling Poulsen, Jakob Espesen, Vibeke Stevenius Ringsdal, Niels Graudal, Gina Birgitte Kollerup, Dorte Vendelbo Jensen, Ole Rintek Madsen, Bente Glintborg, Torben Steen Christensen, Hanne Lindegaard, Ditte Dencker, Annette Hansen, Anne Rødgaard Andersen, Merete Lund Hetland

23 Citations (Scopus)

Abstract

Objectives: To compare radiographic progression during treatment with disease-modifying antirheumatic drugs (DMARD) and subsequent treatment with tumour necrosis factor α inhibitors (TNF-I) in rheumatoid arthritis (RA) patients in clinical practice. Methods: Conventional radiographs (x-rays) of hands and wrists were obtained ∼2 years before start (prebaseline), at baseline and ∼2 years after start (follow-up) of TNF-I. Clinical data were obtained from the DANBIO registry and the patient files. x-Rays were scored blinded to chronology according to the Sharp/van der Heijde method. Annual radiographic progression rates during the DMARD (prebaseline to baseline x-ray) and TNF-I (baseline to follow-up x-ray) periods were calculated. Results: 517 RA patients (76% women, 80% IgM rheumatoid factor positive, 65% anticyclic citrullinated peptide positive, 40% current smokers, age 54 years (range 21-86), median disease duration 5 years (range 0-57)) were included. Patients were treated with infliximab (61%), etanercept (15%) or adalimumab (24%). During the DMARD period 85% of patients received methotrexate, 51% sulphasalazine and 78% prednisolone. The median DMARD period was 733 days (IQR 484-1002) and the median TNF-I period was 562 days (IQR 405-766). The median radiographic progression rate decreased from 0.7 (IQR 0-2.9) total Sharp score units/year (dTSS) in the DMARD period to 0 (0-0.9) units/year in the TNF-I period (p<0.0001, Wilcoxon). Corresponding mean dTSS values were 2.1 (SD 3.7) versus 0.7 (SD 2.3) units/year (p<0.0001, paired t test). 305 patients progressed (dTSS >0) in the DMARD period compared with 158 patients in the TNF-I period (p<0.0001, χ²). Conclusion: This nationwide observational study of RA patients documented significantly reduced radiographic progression during TNF-I treatment compared with the previous period of DMARD treatment.

Original language	English
Journal	Annals of the Rheumatic Diseases
Volume	72
Issue number	1
Pages (from-to)	57-63
Number of pages	7
ISSN	0003-4967
DOIs	https://doi.org/10.1136/annrheumdis-2012-201319
Publication status	Published - Jan 2013

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Ørnbjerg, L. M., Østergaard, M., Bøyesen, P., Krogh, N. S., Thormann, A., Tarp, U., Poulsen, U. E., Espesen, J., Ringsdal, V. S., Graudal, N., Kollerup, G. B., Jensen, D. V., Madsen, O. R., Glintborg, B., Christensen, T. S., Lindegaard, H., Dencker, D., Hansen, A., Andersen, A. R., & Hetland, M. L. (2013). Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice: results from the nationwide Danish DANBIO registry. Annals of the Rheumatic Diseases, 72(1), 57-63. https://doi.org/10.1136/annrheumdis-2012-201319

Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice: results from the nationwide Danish DANBIO registry. / Ørnbjerg, Lykke Midtbøll; Østergaard, Mikkel; Bøyesen, Pernille et al.
In: Annals of the Rheumatic Diseases, Vol. 72, No. 1, 01.2013, p. 57-63.

Research output: Contribution to journal › Journal article › Research › peer-review

Ørnbjerg, LM, Østergaard, M, Bøyesen, P, Krogh, NS, Thormann, A, Tarp, U, Poulsen, UE, Espesen, J, Ringsdal, VS, Graudal, N, Kollerup, GB, Jensen, DV, Madsen, OR, Glintborg, B, Christensen, TS, Lindegaard, H, Dencker, D, Hansen, A, Andersen, AR & Hetland, ML 2013, 'Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice: results from the nationwide Danish DANBIO registry', Annals of the Rheumatic Diseases, vol. 72, no. 1, pp. 57-63. https://doi.org/10.1136/annrheumdis-2012-201319

@article{baf02a6c3694423fb8de75105b6ad436,

title = "Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice: results from the nationwide Danish DANBIO registry",

abstract = "Objectives: To compare radiographic progression during treatment with disease-modifying antirheumatic drugs (DMARD) and subsequent treatment with tumour necrosis factor α inhibitors (TNF-I) in rheumatoid arthritis (RA) patients in clinical practice. Methods: Conventional radiographs (x-rays) of hands and wrists were obtained ∼2 years before start (prebaseline), at baseline and ∼2 years after start (follow-up) of TNF-I. Clinical data were obtained from the DANBIO registry and the patient files. x-Rays were scored blinded to chronology according to the Sharp/van der Heijde method. Annual radiographic progression rates during the DMARD (prebaseline to baseline x-ray) and TNF-I (baseline to follow-up x-ray) periods were calculated. Results: 517 RA patients (76% women, 80% IgM rheumatoid factor positive, 65% anticyclic citrullinated peptide positive, 40% current smokers, age 54 years (range 21-86), median disease duration 5 years (range 0-57)) were included. Patients were treated with infliximab (61%), etanercept (15%) or adalimumab (24%). During the DMARD period 85% of patients received methotrexate, 51% sulphasalazine and 78% prednisolone. The median DMARD period was 733 days (IQR 484-1002) and the median TNF-I period was 562 days (IQR 405-766). The median radiographic progression rate decreased from 0.7 (IQR 0-2.9) total Sharp score units/year (dTSS) in the DMARD period to 0 (0-0.9) units/year in the TNF-I period (p<0.0001, Wilcoxon). Corresponding mean dTSS values were 2.1 (SD 3.7) versus 0.7 (SD 2.3) units/year (p<0.0001, paired t test). 305 patients progressed (dTSS >0) in the DMARD period compared with 158 patients in the TNF-I period (p<0.0001, χ2). Conclusion: This nationwide observational study of RA patients documented significantly reduced radiographic progression during TNF-I treatment compared with the previous period of DMARD treatment.",

author = "{\O}rnbjerg, {Lykke Midtb{\o}ll} and Mikkel {\O}stergaard and Pernille B{\o}yesen and Krogh, {Niels Steen} and Anja Thormann and Ulrik Tarp and Poulsen, {Uta Engling} and Jakob Espesen and Ringsdal, {Vibeke Stevenius} and Niels Graudal and Kollerup, {Gina Birgitte} and Jensen, {Dorte Vendelbo} and Madsen, {Ole Rintek} and Bente Glintborg and Christensen, {Torben Steen} and Hanne Lindegaard and Ditte Dencker and Annette Hansen and Andersen, {Anne R{\o}dgaard} and Hetland, {Merete Lund}",

year = "2013",

month = jan,

doi = "10.1136/annrheumdis-2012-201319",

language = "English",

volume = "72",

pages = "57--63",

journal = "Annals of the Rheumatic Diseases",

issn = "0003-4967",

publisher = "B M J Group",

number = "1",

}

TY - JOUR

T1 - Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice

T2 - results from the nationwide Danish DANBIO registry

AU - Ørnbjerg, Lykke Midtbøll

AU - Østergaard, Mikkel

AU - Bøyesen, Pernille

AU - Krogh, Niels Steen

AU - Thormann, Anja

AU - Tarp, Ulrik

AU - Poulsen, Uta Engling

AU - Espesen, Jakob

AU - Ringsdal, Vibeke Stevenius

AU - Graudal, Niels

AU - Kollerup, Gina Birgitte

AU - Jensen, Dorte Vendelbo

AU - Madsen, Ole Rintek

AU - Glintborg, Bente

AU - Christensen, Torben Steen

AU - Lindegaard, Hanne

AU - Dencker, Ditte

AU - Hansen, Annette

AU - Andersen, Anne Rødgaard

AU - Hetland, Merete Lund

PY - 2013/1

Y1 - 2013/1

N2 - Objectives: To compare radiographic progression during treatment with disease-modifying antirheumatic drugs (DMARD) and subsequent treatment with tumour necrosis factor α inhibitors (TNF-I) in rheumatoid arthritis (RA) patients in clinical practice. Methods: Conventional radiographs (x-rays) of hands and wrists were obtained ∼2 years before start (prebaseline), at baseline and ∼2 years after start (follow-up) of TNF-I. Clinical data were obtained from the DANBIO registry and the patient files. x-Rays were scored blinded to chronology according to the Sharp/van der Heijde method. Annual radiographic progression rates during the DMARD (prebaseline to baseline x-ray) and TNF-I (baseline to follow-up x-ray) periods were calculated. Results: 517 RA patients (76% women, 80% IgM rheumatoid factor positive, 65% anticyclic citrullinated peptide positive, 40% current smokers, age 54 years (range 21-86), median disease duration 5 years (range 0-57)) were included. Patients were treated with infliximab (61%), etanercept (15%) or adalimumab (24%). During the DMARD period 85% of patients received methotrexate, 51% sulphasalazine and 78% prednisolone. The median DMARD period was 733 days (IQR 484-1002) and the median TNF-I period was 562 days (IQR 405-766). The median radiographic progression rate decreased from 0.7 (IQR 0-2.9) total Sharp score units/year (dTSS) in the DMARD period to 0 (0-0.9) units/year in the TNF-I period (p<0.0001, Wilcoxon). Corresponding mean dTSS values were 2.1 (SD 3.7) versus 0.7 (SD 2.3) units/year (p<0.0001, paired t test). 305 patients progressed (dTSS >0) in the DMARD period compared with 158 patients in the TNF-I period (p<0.0001, χ2). Conclusion: This nationwide observational study of RA patients documented significantly reduced radiographic progression during TNF-I treatment compared with the previous period of DMARD treatment.

AB - Objectives: To compare radiographic progression during treatment with disease-modifying antirheumatic drugs (DMARD) and subsequent treatment with tumour necrosis factor α inhibitors (TNF-I) in rheumatoid arthritis (RA) patients in clinical practice. Methods: Conventional radiographs (x-rays) of hands and wrists were obtained ∼2 years before start (prebaseline), at baseline and ∼2 years after start (follow-up) of TNF-I. Clinical data were obtained from the DANBIO registry and the patient files. x-Rays were scored blinded to chronology according to the Sharp/van der Heijde method. Annual radiographic progression rates during the DMARD (prebaseline to baseline x-ray) and TNF-I (baseline to follow-up x-ray) periods were calculated. Results: 517 RA patients (76% women, 80% IgM rheumatoid factor positive, 65% anticyclic citrullinated peptide positive, 40% current smokers, age 54 years (range 21-86), median disease duration 5 years (range 0-57)) were included. Patients were treated with infliximab (61%), etanercept (15%) or adalimumab (24%). During the DMARD period 85% of patients received methotrexate, 51% sulphasalazine and 78% prednisolone. The median DMARD period was 733 days (IQR 484-1002) and the median TNF-I period was 562 days (IQR 405-766). The median radiographic progression rate decreased from 0.7 (IQR 0-2.9) total Sharp score units/year (dTSS) in the DMARD period to 0 (0-0.9) units/year in the TNF-I period (p<0.0001, Wilcoxon). Corresponding mean dTSS values were 2.1 (SD 3.7) versus 0.7 (SD 2.3) units/year (p<0.0001, paired t test). 305 patients progressed (dTSS >0) in the DMARD period compared with 158 patients in the TNF-I period (p<0.0001, χ2). Conclusion: This nationwide observational study of RA patients documented significantly reduced radiographic progression during TNF-I treatment compared with the previous period of DMARD treatment.

U2 - 10.1136/annrheumdis-2012-201319

DO - 10.1136/annrheumdis-2012-201319

M3 - Journal article

C2 - 22532636

SN - 0003-4967

VL - 72

SP - 57

EP - 63

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

IS - 1

ER -

Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice: results from the nationwide Danish DANBIO registry

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