Which factors influence radiographic progression during treatment with tumor necrosis factor inhibitors in clinical practice?: Results from 930 patients with rheumatoid arthritis in the nationwide Danish DANBIO registry

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

doi:10.3899/jrheum.131299

Which factors influence radiographic progression during treatment with tumor necrosis factor inhibitors in clinical practice? Results from 930 patients with rheumatoid arthritis in the nationwide Danish DANBIO registry

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

Department of Clinical Medicine

9 Citations (Scopus)

Abstract

OBJECTIVE: To investigate baseline characteristics associated with radiographic progression and the effect of disease activity, drug, switching, and withdrawal on radiographic progression in tumor necrosis factor (TNF) inhibitor-naive patients with rheumatoid arthritis (RA) followed for about 2 years after anti-TNF initiation in clinical practice.

METHODS: DANBIO-registered patients with RA who had available radiographs (anti-TNF initiation and ∼2 yrs followup) were included. Radiographs were scored, blinded to chronology with the Sharp/van der Heijde method and linked with DANBIO data. Baseline characteristics were investigated with univariate regression and significant variables included in a multivariable logistic regression analysis with ± radiographic progression [Δ total Sharp score (TSS) > 0] as dependent variable. Effect of time-averaged C-reactive protein (CRP), 28-joint Disease Activity Score with CRP (DAS28-CRP), and treatment status at followup were investigated with univariate regression analysis.

RESULTS: The study included 930 patients. They were 75% women, 79% positive for IgM-rheumatoid factor (IgM-RF), median age was 57 yrs (range 19-88), disease duration 9 yrs (1-59), DAS28-CRP 5.0 (1.4-7.8), TSS median 15 [3-45 interquartile range (IQR)] and mean 31 (SD 40). Patients started treatment with infliximab (59%), etanercept (18%), or adalimumab (23%). At followup (median 526 days, IQR 392-735), 61% were treated with the initial anti-TNF, 29% had switched TNF inhibitor, and 10% had withdrawn. Twenty-seven percent of patients had progressed radiographically. ΔTSS was median 0.0 [0.0-0.5 IQR/mean 0.6 (SD 2.4)] units/year. Higher TSS, older age, positive IgM-RF, and concomitant prednisolone at baseline were associated with radiographic progression. Time-averaged DAS28-CRP and time-averaged CRP, but not type of TNF inhibitor, were associated with radiographic progression. Patients who stopped/switched during followup progressed more than patients who continued treatment.

CONCLUSION: High TSS, older age, IgM-RF positivity, and concomitant prednisolone were associated with radiographic progression during 2 years of followup of 930 anti-TNF-treated patients with RA in clinical practice. High disease activity and switching/stopping anti-TNF treatment were associated with radiographic progression.

Original language	English
Journal	Journal of Rheumatology
Volume	41
Issue number	12
Pages (from-to)	2352-60
Number of pages	9
ISSN	0315-162X
DOIs	https://doi.org/10.3899/jrheum.131299
Publication status	Published - 1 Dec 2014

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Ørnbjerg, L. M., Østergaard, M., Bøyesen, P., Krogh, N. S., Thormann, A., Tarp, U., Poulsen, U. E., Espesen, J., Schlemmer, A., Graudal, N., Kollerup, G., Jensen, D. V., Madsen, O. R., Glintborg, B., Christensen, T., Lindegaard, H., Bøhme, W., Hansen, A., Andersen, A. R., & Hetland, M. L. (2014). Which factors influence radiographic progression during treatment with tumor necrosis factor inhibitors in clinical practice? Results from 930 patients with rheumatoid arthritis in the nationwide Danish DANBIO registry. Journal of Rheumatology, 41(12), 2352-60. https://doi.org/10.3899/jrheum.131299

Which factors influence radiographic progression during treatment with tumor necrosis factor inhibitors in clinical practice? Results from 930 patients with rheumatoid arthritis in the nationwide Danish DANBIO registry. / Ørnbjerg, Lykke Midtbøll; Østergaard, Mikkel; Bøyesen, Pernille et al.
In: Journal of Rheumatology, Vol. 41, No. 12, 01.12.2014, p. 2352-60.

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, Schlemmer, A, Graudal, N, Kollerup, G, Jensen, DV, Madsen, OR , Glintborg, B, Christensen, T, Lindegaard, H, Bøhme, W, Hansen, A, Andersen, AR & Hetland, ML 2014, 'Which factors influence radiographic progression during treatment with tumor necrosis factor inhibitors in clinical practice? Results from 930 patients with rheumatoid arthritis in the nationwide Danish DANBIO registry', Journal of Rheumatology, vol. 41, no. 12, pp. 2352-60. https://doi.org/10.3899/jrheum.131299

Ørnbjerg LM, Østergaard M, Bøyesen P, Krogh NS, Thormann A, Tarp U et al. Which factors influence radiographic progression during treatment with tumor necrosis factor inhibitors in clinical practice? Results from 930 patients with rheumatoid arthritis in the nationwide Danish DANBIO registry. Journal of Rheumatology. 2014 Dec 1;41(12):2352-60. doi: 10.3899/jrheum.131299

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title = "Which factors influence radiographic progression during treatment with tumor necrosis factor inhibitors in clinical practice?: Results from 930 patients with rheumatoid arthritis in the nationwide Danish DANBIO registry",

abstract = "OBJECTIVE: To investigate baseline characteristics associated with radiographic progression and the effect of disease activity, drug, switching, and withdrawal on radiographic progression in tumor necrosis factor (TNF) inhibitor-naive patients with rheumatoid arthritis (RA) followed for about 2 years after anti-TNF initiation in clinical practice.METHODS: DANBIO-registered patients with RA who had available radiographs (anti-TNF initiation and ∼2 yrs followup) were included. Radiographs were scored, blinded to chronology with the Sharp/van der Heijde method and linked with DANBIO data. Baseline characteristics were investigated with univariate regression and significant variables included in a multivariable logistic regression analysis with ± radiographic progression [Δ total Sharp score (TSS) > 0] as dependent variable. Effect of time-averaged C-reactive protein (CRP), 28-joint Disease Activity Score with CRP (DAS28-CRP), and treatment status at followup were investigated with univariate regression analysis.RESULTS: The study included 930 patients. They were 75% women, 79% positive for IgM-rheumatoid factor (IgM-RF), median age was 57 yrs (range 19-88), disease duration 9 yrs (1-59), DAS28-CRP 5.0 (1.4-7.8), TSS median 15 [3-45 interquartile range (IQR)] and mean 31 (SD 40). Patients started treatment with infliximab (59%), etanercept (18%), or adalimumab (23%). At followup (median 526 days, IQR 392-735), 61% were treated with the initial anti-TNF, 29% had switched TNF inhibitor, and 10% had withdrawn. Twenty-seven percent of patients had progressed radiographically. ΔTSS was median 0.0 [0.0-0.5 IQR/mean 0.6 (SD 2.4)] units/year. Higher TSS, older age, positive IgM-RF, and concomitant prednisolone at baseline were associated with radiographic progression. Time-averaged DAS28-CRP and time-averaged CRP, but not type of TNF inhibitor, were associated with radiographic progression. Patients who stopped/switched during followup progressed more than patients who continued treatment.CONCLUSION: High TSS, older age, IgM-RF positivity, and concomitant prednisolone were associated with radiographic progression during 2 years of followup of 930 anti-TNF-treated patients with RA in clinical practice. High disease activity and switching/stopping anti-TNF treatment were associated with radiographic progression.",

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 Annette Schlemmer and Niels Graudal and Gina Kollerup and Jensen, {Dorte Vendelbo} and Madsen, {Ole Rintek} and Bente Glintborg and Torben Christensen and Hanne Lindegaard and Wolfgang B{\o}hme and Annette Hansen and Andersen, {Anne R{\o}dgaard} and Hetland, {Merete Lund}",

year = "2014",

month = dec,

day = "1",

doi = "10.3899/jrheum.131299",

language = "English",

volume = "41",

pages = "2352--60",

journal = "Journal of Rheumatology",

issn = "0315-162X",

publisher = "Journal of Rheumatology Publishing Co. Ltd.",

number = "12",

}

TY - JOUR

T1 - Which factors influence radiographic progression during treatment with tumor necrosis factor inhibitors in clinical practice?

T2 - Results from 930 patients with rheumatoid arthritis in 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 - Schlemmer, Annette

AU - Graudal, Niels

AU - Kollerup, Gina

AU - Jensen, Dorte Vendelbo

AU - Madsen, Ole Rintek

AU - Glintborg, Bente

AU - Christensen, Torben

AU - Lindegaard, Hanne

AU - Bøhme, Wolfgang

AU - Hansen, Annette

AU - Andersen, Anne Rødgaard

AU - Hetland, Merete Lund

PY - 2014/12/1

Y1 - 2014/12/1

N2 - OBJECTIVE: To investigate baseline characteristics associated with radiographic progression and the effect of disease activity, drug, switching, and withdrawal on radiographic progression in tumor necrosis factor (TNF) inhibitor-naive patients with rheumatoid arthritis (RA) followed for about 2 years after anti-TNF initiation in clinical practice.METHODS: DANBIO-registered patients with RA who had available radiographs (anti-TNF initiation and ∼2 yrs followup) were included. Radiographs were scored, blinded to chronology with the Sharp/van der Heijde method and linked with DANBIO data. Baseline characteristics were investigated with univariate regression and significant variables included in a multivariable logistic regression analysis with ± radiographic progression [Δ total Sharp score (TSS) > 0] as dependent variable. Effect of time-averaged C-reactive protein (CRP), 28-joint Disease Activity Score with CRP (DAS28-CRP), and treatment status at followup were investigated with univariate regression analysis.RESULTS: The study included 930 patients. They were 75% women, 79% positive for IgM-rheumatoid factor (IgM-RF), median age was 57 yrs (range 19-88), disease duration 9 yrs (1-59), DAS28-CRP 5.0 (1.4-7.8), TSS median 15 [3-45 interquartile range (IQR)] and mean 31 (SD 40). Patients started treatment with infliximab (59%), etanercept (18%), or adalimumab (23%). At followup (median 526 days, IQR 392-735), 61% were treated with the initial anti-TNF, 29% had switched TNF inhibitor, and 10% had withdrawn. Twenty-seven percent of patients had progressed radiographically. ΔTSS was median 0.0 [0.0-0.5 IQR/mean 0.6 (SD 2.4)] units/year. Higher TSS, older age, positive IgM-RF, and concomitant prednisolone at baseline were associated with radiographic progression. Time-averaged DAS28-CRP and time-averaged CRP, but not type of TNF inhibitor, were associated with radiographic progression. Patients who stopped/switched during followup progressed more than patients who continued treatment.CONCLUSION: High TSS, older age, IgM-RF positivity, and concomitant prednisolone were associated with radiographic progression during 2 years of followup of 930 anti-TNF-treated patients with RA in clinical practice. High disease activity and switching/stopping anti-TNF treatment were associated with radiographic progression.

AB - OBJECTIVE: To investigate baseline characteristics associated with radiographic progression and the effect of disease activity, drug, switching, and withdrawal on radiographic progression in tumor necrosis factor (TNF) inhibitor-naive patients with rheumatoid arthritis (RA) followed for about 2 years after anti-TNF initiation in clinical practice.METHODS: DANBIO-registered patients with RA who had available radiographs (anti-TNF initiation and ∼2 yrs followup) were included. Radiographs were scored, blinded to chronology with the Sharp/van der Heijde method and linked with DANBIO data. Baseline characteristics were investigated with univariate regression and significant variables included in a multivariable logistic regression analysis with ± radiographic progression [Δ total Sharp score (TSS) > 0] as dependent variable. Effect of time-averaged C-reactive protein (CRP), 28-joint Disease Activity Score with CRP (DAS28-CRP), and treatment status at followup were investigated with univariate regression analysis.RESULTS: The study included 930 patients. They were 75% women, 79% positive for IgM-rheumatoid factor (IgM-RF), median age was 57 yrs (range 19-88), disease duration 9 yrs (1-59), DAS28-CRP 5.0 (1.4-7.8), TSS median 15 [3-45 interquartile range (IQR)] and mean 31 (SD 40). Patients started treatment with infliximab (59%), etanercept (18%), or adalimumab (23%). At followup (median 526 days, IQR 392-735), 61% were treated with the initial anti-TNF, 29% had switched TNF inhibitor, and 10% had withdrawn. Twenty-seven percent of patients had progressed radiographically. ΔTSS was median 0.0 [0.0-0.5 IQR/mean 0.6 (SD 2.4)] units/year. Higher TSS, older age, positive IgM-RF, and concomitant prednisolone at baseline were associated with radiographic progression. Time-averaged DAS28-CRP and time-averaged CRP, but not type of TNF inhibitor, were associated with radiographic progression. Patients who stopped/switched during followup progressed more than patients who continued treatment.CONCLUSION: High TSS, older age, IgM-RF positivity, and concomitant prednisolone were associated with radiographic progression during 2 years of followup of 930 anti-TNF-treated patients with RA in clinical practice. High disease activity and switching/stopping anti-TNF treatment were associated with radiographic progression.

U2 - 10.3899/jrheum.131299

DO - 10.3899/jrheum.131299

M3 - Journal article

C2 - 25274894

SN - 0315-162X

VL - 41

SP - 2352

EP - 2360

JO - Journal of Rheumatology

JF - Journal of Rheumatology

IS - 12

ER -