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Observational Study
. 2025 May;28(5):e70274.
doi: 10.1111/1756-185X.70274.

Real-World Insights From Türkiye: Biologic DMARDs Usage in Spondyloarthritis Patients With Chronic Kidney Disease

Dilara Bulut Gökten  1 , Mehmet Engin Tezcan  2 , Burcu Yağız  3 , Abdulsamet Erden  4 , Gezmiş Kimyon  5 , Nazife Şule Yaşar Bilge  6 , Levent Kılıç  7 , Belkıs Nihan Coşkun  3 , Emine Duygu Ersözlü  8 , Orhan Küçükşahin  9 , Süleyman Serdar Koca  10 , Emel Gönüllü  11 , Muhammet Çınar  12 , Servet Akar  13 , Hakan Emmungil  14 , Timuçin Kaşifoğlu  6 , Cemal Bes  15 , Aşkın Ateş  16 , Yavuz Pehlivan  3 , Sedat Kiraz  7 , Ali İhsan Ertenli  7 , Hüseyin Ediz Dalkılıç  3 , Umut Kalyoncu  7 , Rıdvan Mercan  1
Affiliations
Observational Study

Real-World Insights From Türkiye: Biologic DMARDs Usage in Spondyloarthritis Patients With Chronic Kidney Disease

Dilara Bulut Gökten et al. Int J Rheum Dis. 2025 May.

Abstract

Aim: The objective was to evaluate biologic disease-modifying antirheumatic drugs (DMARDs) and their side effects that hindered the continuation of treatment in a patient population diagnosed with spondyloarthritis (SpA) with a glomerular filtration rate (GFR) ≤ 60 mL/min, and to compare these side effects between patients with chronic kidney disease (CKD) and those without.

Methods: This multicenter, observational cohort study utilized data from the TReasure database, which records SpA patients in a web-based system across Türkiye. A total of 6052 patients being included. SpA patients were categorized into two main groups: non-CKD patients and CKD patients. The clinical characteristics, disease activity, treatment options, drug retention rates, reasons for drug discontinuation, and types of adverse effects were compared between the groups.

Results: Biologics prescription pattern varied between CKD and non-CKD patients. Etanercept was prescribed more frequently (53.1%) in CKD patients. Regarding the number of side effects and drug discontinuations in CKD patients, no statistically significant differences were found between the non-CKD and CKD groups for any of the bDMARDs (adalimumab, etanercept, golimumab, infliximab, ustekinumab, secukinumab, and certolizumab). No statistically significant differences were observed in the duration of drug retention based on CKD status for bDMARDs.

Conclusion: This study offers preliminary evidence supporting the effective and safe use of bDMARDs in patients with SpA and CKD.

Keywords: adverse event; biologic DMARDs; chronic kidney disease; safe use; spondylarthritis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Baseline, first visit, and second visit BASDAI scores evaluated in CKD and non‐CKD patients.
FIGURE 2
FIGURE 2
Baseline, first visit, and second visit ASDAS‐CRP scores evaluated in CKD and non‐CKD patients.
See this image and copyright information in PMC

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