Second and third TNF inhibitors in European patients with axial spondyloarthritis: effectiveness and impact of the reason for switching-Reference-Cited by-同舟云学术

Second and third TNF inhibitors in European patients with axial spondyloarthritis: effectiveness and impact of the reason for switching

Published:2023-09-20 Issue: Volume: Page:
ISSN:1462-0324
Container-title:Rheumatology
language:en
Short-container-title:

Author:

Linde Louise¹²^ORCID,Ørnbjerg Lykke Midtbøll¹²^ORCID,Heegaard Brahe Cecilie¹,Wallman Johan Karlsson³^ORCID,Di Giuseppe Daniela⁴^ORCID,Závada Jakub⁵,Castrejon Isabel⁶^ORCID,Díaz-Gonzalez Federico⁷^ORCID,Rotar Ziga⁸,Tomšič Matija⁸,Glintborg Bente¹²⁹^ORCID,Gudbjornsson Bjorn¹⁰,Geirsson Arni Jon¹¹,Michelsen Brigitte¹¹²¹³,Kristianslund Eirik Klami¹²,Santos Maria José¹⁴^ORCID,Barcelos Anabela¹⁵,Nordström Dan¹⁶,Eklund Kari K¹⁷,Ciurea Adrian¹⁸^ORCID,Nissen Michael¹⁹^ORCID,Akar Servet²⁰,Hejl Hyldstrup Lise¹,Krogh Niels Steen²¹,Hetland Merete Lund¹⁹^ORCID,Østergaard Mikkel¹⁹^ORCID

Affiliation:

1. Center for Rheumatology and Spine Diseases, Center for Head and Orthopaedics, Copenhagen Center for Arthritis Research (COPECARE), Rigshospitalet , Glostrup, Denmark

2. DANBIO Registry, Center for Rheumatology and Spine Diseases, Center for Head and Orthopaedics, Rigshospitalet , Glostrup, Denmark

3. Department of Clinical Sciences Lund, Rheumatology, Skåne University Hospital, Lund University , Lund, Sweden

4. Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet , Stockholm, Sweden

5. Institute of Rheumatology and Department of Rheumatology, 1st Faculty of Medicine, Charles University , Prague, Czech Republic

6. Department of Rheumatology, Hospital General Universitario Gregorio Marañón and Faculty of Medicine, Complutense University of Madrid , Madrid, Spain

7. Department of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna and Rheumatology Service, Hospital Universitario de Canarias , La Laguna, Spain

8. Department of Rheumatology, University Medical Centre Ljubljana and Faculty of Medicine, University of Ljubljana , Ljubljana, Slovenia

9. Department of Clinical Medicine, University of Copenhagen , Copenhagen, Denmark

10. Centre for Rheumatology Research (ICEBIO), Landspitali University Hospital, Reykjavik, Iceland and Faculty of Medicine, University of Iceland , Reykjavik, Iceland

11. Department of Rheumatology, University Hospital , Reykjavik, Iceland

12. Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital , Oslo, Norway

13. Research Unit, Sørlandet Hospital , Kristiansand, Norway

14. Department of Rheumatology, Hospital Garcia de Orta, Almada and Instituto Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa , Lisbon, Portugal

15. Department of Rheumatology, Centro Hospitalar do Baixo Vouga, Aveiro and Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa , Lisbon, Portugal

16. Departments of Medicine and Rheumatology, Helsinki University Hospital , Helsinki, Finland

17. Inflammation Center, Department of Rheumatology, Helsinki University Hospital , Helsinki, Finland

18. Department of Rheumatology, University Hospital Zurich, University of Zurich , Zurich, Switzerland

19. Department of Rheumatology, Geneva University Hospital , Geneva, Switzerland

20. School of Medicine, Department of Internal Medicine, Division of Rheumatology, Izmir Katip Celebi University , Izmir, Turkey

21. Zitelab ApS , Copenhagen, Denmark

Abstract

Abstract Objective To investigate real-world effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA) and the association with (i) treatment line (second and third TNFi-series) and (ii) reason for withdrawal from the preceding TNFi [lack of efficacy (LOE) vs adverse events (AE)]. Methods Prospectively collected routine care data from 12 European registries were pooled. Rates for 12-month drug retention and 6-month remission [Ankylosing Spondylitis Disease Activity Score C-reactive protein inactive disease (ASDAS-ID)] were assessed in second and third TNFi-series and stratified by withdrawal reason. Results We included 8254 s and 2939 third TNFi-series; 12-month drug retention rates were similar (71%). Six-month ASDAS-ID rates were higher for the second (23%) than third TNFi (16%). Twelve-month drug retention rates for patients withdrawing from the preceding TNFi due to AE vs LOE were similar for the second (68% and 67%) and third TNFi (both 68%), while for the second TNFi, rates were lower in primary than secondary non-responders (LOE <26 vs ≥26 weeks) (58% vs 71%, P < 0.001). Six-month ASDAS-ID rates for the second TNFi were higher if the withdrawal reason was AE (27%) vs LOE (17%), P < 0.001, while similar for the third TNFi (19% vs 13%, P = 0.20). Conclusion A similar proportion of axSpA patients remained on a second and third TNFi after one year, but with low remission rates for the third TNFi. Remission rates on the second TNFi (but not the third) were higher if the withdrawal reason from the preceding TNFi was AE vs LOE.

Funder

Novartis Pharma AG

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Rheumatology

Link

https://academic.oup.com/rheumatology/advance-article-pdf/doi/10.1093/rheumatology/kead494/51907423/kead494.pdf

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