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. 2024 Mar 1;63(3):751-764.
doi: 10.1093/rheumatology/kead284.

Predictors of DAPSA28 remission in patients with psoriatic arthritis initiating a first TNF inhibitor: results from 13 European registries

Louise Linde  1   2 , Lykke M Ørnbjerg  1   2 , Stylianos Georgiadis  1   2 , Simon H Rasmussen  1 , Ulf Lindström  3 , Johan Askling  4 , Brigitte Michelsen  1   5   6 , Daniela Di Giuseppe  7 , Johan K Wallman  8 , Bjorn Gudbjornsson  9   10 , Thorvardur Jon Love  10   11 , Dan C Nordström  12 , Timo Yli-Kerttula  13 , Lucie Nekvindová  14   15 , Jiří Vencovský  14   15 , Florenzo Iannone  16 , Alberto Cauli  17 , Anne Gitte Loft  18   19 , Bente Glintborg  1   2   20 , Karin Laas  21 , Ziga Rotar  22   23 , Matija Tomšič  22   23 , Gary J Macfarlane  24 , Burkhard Möller  25 , Marleen van de Sande  26   27 , Catalin Codreanu  28 , Michael J Nissen  29 , Merih Birlik  30 , Sukran Erten  31 , Maria J Santos  32   33 , Elsa Vieira-Sousa  34 , Merete L Hetland  1   20 , Mikkel Østergaard  1   20
Affiliations

Predictors of DAPSA28 remission in patients with psoriatic arthritis initiating a first TNF inhibitor: results from 13 European registries

Louise Linde et al. Rheumatology (Oxford). .

Abstract

Objectives: In bio-naïve patients with PsA initiating a TNF inhibitor (TNFi), we aimed to identify baseline predictors of Disease Activity index for PsA in 28 joints (DAPSA28) remission (primary objective) and DAPSA28 moderate response at 6 months, as well as drug retention at 12 months across 13 European registries.

Methods: Baseline demographic and clinical characteristics were retrieved and the three outcomes investigated per registry and in pooled data, using logistic regression analyses on multiply imputed data. In the pooled cohort, selected predictors that were either consistently positive or negative across all three outcomes were defined as common predictors.

Results: In the pooled cohort (n = 13 369), 6-month proportions of remission, moderate response and 12-month drug retention were 25%, 34% and 63% in patients with available data (n = 6954, n = 5275 and n = 13 369, respectively). Five common baseline predictors of remission, moderate response and 12-month drug retention were identified across all three outcomes. The odds ratios (95% CIs) for DAPSA28 remission were: age, per year: 0.97 (0.96-0.98); disease duration, years (<2 years as reference): 2-3 years: 1.20 (0.89-1.60), 4-9 years: 1.42 (1.09-1.84), ≥10 years: 1.66 (1.26-2.20); men vs women: 1.85 (1.54-2.23); CRP of >10 vs ≤10 mg/l: 1.52 (1.22-1.89) and 1 mm increase in patient fatigue score: 0.99 (0.98-0.99).

Conclusion: Baseline predictors of remission, response and adherence to TNFi therapy were identified, of which five were common for all three outcomes, indicating that the predictors emerging from our pooled cohort may be considered generalizable from country level to disease level.

Keywords: DAPSA28; PsA; drug retention; first TNF-inhibitor; predictors; real-world evidence.

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Figures

Figure 1.
Figure 1.
Classification of patients starting their first TNF-inhibitor with regards to DAPSA28 remission (A) and DAPSA28 moderate response (B) at 6 months.aExcluding Italy and Spain due to no available CRP. bAccording to the opinion of the clinician. cRemission: n = 1723 (panel A)/response: n = 1803 (panel B). dNo remission: n = 5231 (panel A)/no response: n = 3472 (panel B). eIncluding patients stopping TNFi after 6 months for any reason, patients stopping TNFi within 6 months for other reasons, and patients continuing on TNFi but without an assessment. TNFi: TNF inhibitor; DAPSA28: Disease Activity index for PSoriatic Arthritis in 28 joints
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References

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