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. 2022 Aug 30;61(9):3799-3807.
doi: 10.1093/rheumatology/keab945.

European bio-naïve spondyloarthritis patients initiating TNF inhibitor: time trends in baseline characteristics, treatment retention and response

Sara Nysom Christiansen  1 , Lykke Midtbøll Ørnbjerg  1 , Simon Horskjær Rasmussen  1 , Anne Gitte Loft  2   3 , Johan Askling  4 , Florenzo Iannone  5 , Jakub Zavada  6 , Brigitte Michelsen  1   7   8 , Michael Nissen  9 , Fatos Onen  10 , Maria Jose Santos  11 , Manuel Pombo-Suarez  12 , Heikki Relas  13 , Gary J Macfarlane  14 , Matija Tomsic  15 , Catalin Codreanu  16 , Bjorn Gudbjornsson  17 , Irene Van der Horst-Bruinsma  18 , Daniela Di Giuseppe  4 , Bente Glintborg  1   3 , Elisa Gremese  19 , Karel Pavelka  6 , Eirik Klami Kristianslund  7 , Adrian Ciurea  20 , Nurullah Akkoc  21 , Anabela Barcelos  22 , Carlos Sánchez-Piedra  23 , Ritva Peltomaa  13 , Gareth T Jones  14 , Ziga Rotar  15 , Ruxandra Ionescu  16 , Gerdur Grondal  24 , Marleen G H Van de Sande  25 , Karin Laas  26 , Mikkel Østergaard  1   27 , Merete L Hetland  1   3   27
Affiliations

European bio-naïve spondyloarthritis patients initiating TNF inhibitor: time trends in baseline characteristics, treatment retention and response

Sara Nysom Christiansen et al. Rheumatology (Oxford). .

Abstract

Objectives: To investigate time trends in baseline characteristics and retention, remission and response rates in bio-naïve axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) patients initiating TNF inhibitor (TNFi) treatment.

Methods: Prospectively collected data on bio-naïve axSpA and PsA patients from routine care in 15 European countries were pooled. Three cohorts were defined according to year of TNFi initiation: A (1999-2008), B (2009-2014) and C (2015-2018). Retention, remission and response rates were assessed at 6, 12 and 24 months.

Results: In total, 27 149 axSpA and 17 446 PsA patients were included. Cohort A patients had longer disease duration compared with B and C. In axSpA, cohort A had the largest proportion of male and HLA-B27 positive patients. In PsA, baseline disease activity was highest in cohort A. Retention rates in axSpA/PsA were highest in cohort A and differed only slightly between B and C. For all cohorts, disease activity decreased markedly from 0 to 6 months. In axSpA, disease activity at 24 months was highest in cohort A, where also remission and response rates were lowest. In PsA, remission rates at 6 and 12 months tended to be lowest in cohort A. Response rates were at all time points comparable across cohorts, and less between-cohort disease activity differences were seen at 24 months.

Conclusion: Our findings indicate that over the past decades, clinicians have implemented more aggressive treatment strategies in spondyloarthritis. This was illustrated by shorter disease duration at treatment initiation, decreased retention rates and higher remission rates during recent years.

Keywords: TNFi retention; axial spondyloarthritis; psoriatic arthritis; remission; response; time trends.

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