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This study published in Arthritis & Rheumatism looks at response rates and drug survivals of switching TNFi (tumor-necrosis-factor-alpha inhibitor) in psoriatic arthritis patients.
Objective:
To describe switch frequencies and outcomes among patients with psoriatic arthritis switching tumor-necrosis-factor-alpha inhibitor (TNFi) treatment in routine care.
Methods:
Observational cohort study based on the Danish nationwide DANBIO registry. Treatment outcomes were evaluated by ACR20/50/70-responses, EULAR-good-response and 28-joint Disease Activity Score (DAS28)-remission. Kaplan-Meier and regression analyses were used for drug survival analyses and to identify predictors of outcome after switching.
Results:
Of 1,422 patients starting TNFi, 548 patients (39%) switched to a second biological drug during up to 10 years' follow-up. Median follow-up was 2.3 years (interquartile-range, IQR 1.0-4.3 years). Switchers were more frequently women (56%/45%), had shorter disease duration (3 years/4 years), higher Health Assessment Questionnaire (HAQ) (1.1(0.6-1.6)/0.9(0.5-1.4) (median(IQR))), DAS28 (4.8(4.0-5.7)/4.4(3.6-5.2)), visual-analogue-scale (VAS) pain (65(46-77)/62(40-75)mm) and fatigue scores (67(50-83)/64(42-80)mm) (all p<0.05 at start of first TNFi). During the first and second treatment HAQ, DAS28, CRP and VAS-scores had decreased after 6 months' (all p<0.05), median drug survivals were 2.2 vs. 1.3 years (p<0.001). Lower fatigue score increased survival of the second TNFi. After switching, the proportions of patients achieving sustained ACR20/ACR50/ACR70/EULAR-good-response/DAS28-remission after 3-6 months were 22% (number-needed-to-treat, NNT 4.5)/13%(7.9)/5%(20)/19%(5.3)/34%(2.9) respectively. Response rates were lower during the second treatment (compared to first TNFi, all p<0.01). At the 2-year visit, 47% of switchers had achieved ACR20 response. No differences between drug-drug combinations were found.
Conclusion:
39% of psoriatic arthritis patients switched TNFi. Response rates and drug survivals were lower after switching, however, half of switchers had ACR20 response 2 years after starting the first TNFi.
Source: NO LINKS ALLOWED
Objective:
To describe switch frequencies and outcomes among patients with psoriatic arthritis switching tumor-necrosis-factor-alpha inhibitor (TNFi) treatment in routine care.
Methods:
Observational cohort study based on the Danish nationwide DANBIO registry. Treatment outcomes were evaluated by ACR20/50/70-responses, EULAR-good-response and 28-joint Disease Activity Score (DAS28)-remission. Kaplan-Meier and regression analyses were used for drug survival analyses and to identify predictors of outcome after switching.
Results:
Of 1,422 patients starting TNFi, 548 patients (39%) switched to a second biological drug during up to 10 years' follow-up. Median follow-up was 2.3 years (interquartile-range, IQR 1.0-4.3 years). Switchers were more frequently women (56%/45%), had shorter disease duration (3 years/4 years), higher Health Assessment Questionnaire (HAQ) (1.1(0.6-1.6)/0.9(0.5-1.4) (median(IQR))), DAS28 (4.8(4.0-5.7)/4.4(3.6-5.2)), visual-analogue-scale (VAS) pain (65(46-77)/62(40-75)mm) and fatigue scores (67(50-83)/64(42-80)mm) (all p<0.05 at start of first TNFi). During the first and second treatment HAQ, DAS28, CRP and VAS-scores had decreased after 6 months' (all p<0.05), median drug survivals were 2.2 vs. 1.3 years (p<0.001). Lower fatigue score increased survival of the second TNFi. After switching, the proportions of patients achieving sustained ACR20/ACR50/ACR70/EULAR-good-response/DAS28-remission after 3-6 months were 22% (number-needed-to-treat, NNT 4.5)/13%(7.9)/5%(20)/19%(5.3)/34%(2.9) respectively. Response rates were lower during the second treatment (compared to first TNFi, all p<0.01). At the 2-year visit, 47% of switchers had achieved ACR20 response. No differences between drug-drug combinations were found.
Conclusion:
39% of psoriatic arthritis patients switched TNFi. Response rates and drug survivals were lower after switching, however, half of switchers had ACR20 response 2 years after starting the first TNFi.
Source: NO LINKS ALLOWED