Lars Erik Kristensen1, Elisabeth Lie2, Lennart T H Jacobsson2, Robin Christensen2, Philip J Mease2, Henning Bliddal2, Pierre Geborek2. 1. From the Department of Rheumatology, and Musculoskeletal Statistics Unit, the Parker Institute, Copenhagen, Denmark; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Rheumatology, Sahlgrenska University, Gothenburg; Department of Rheumatology, Lund University Hospital, Lund, Sweden; Copenhagen University Hospital at Frederiksberg, Frederiksberg, Denmark.L.E. Kristensen, MD, PhD, Department of Rheumatology, the Parker Institute, and Department of Rheumatology, Lund University Hospital; E. Lie, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; L.T. Jacobsson, MD, PhD, Department of Rheumatology, Sahlgrenska University; R. Christensen, MD, PhD, Copenhagen University Hospital at Frederiksberg, and Musculoskeletal Statistics Unit, the Parker Institute; P.J. Mease, MD, PhD, Department of Rheumatology, Swedish Medical Center; H. Bliddal, MD, PhD, Copenhagen University Hospital at Frederiksberg, and Musculoskeletal Statistics Unit, the Parker Institute; P. Geborek, MD, PhD, Department of Rheumatology, Lund University Hospital. Larserik_kristensen@yahoo.com. 2. From the Department of Rheumatology, and Musculoskeletal Statistics Unit, the Parker Institute, Copenhagen, Denmark; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Rheumatology, Sahlgrenska University, Gothenburg; Department of Rheumatology, Lund University Hospital, Lund, Sweden; Copenhagen University Hospital at Frederiksberg, Frederiksberg, Denmark.L.E. Kristensen, MD, PhD, Department of Rheumatology, the Parker Institute, and Department of Rheumatology, Lund University Hospital; E. Lie, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; L.T. Jacobsson, MD, PhD, Department of Rheumatology, Sahlgrenska University; R. Christensen, MD, PhD, Copenhagen University Hospital at Frederiksberg, and Musculoskeletal Statistics Unit, the Parker Institute; P.J. Mease, MD, PhD, Department of Rheumatology, Swedish Medical Center; H. Bliddal, MD, PhD, Copenhagen University Hospital at Frederiksberg, and Musculoskeletal Statistics Unit, the Parker Institute; P. Geborek, MD, PhD, Department of Rheumatology, Lund University Hospital.
Abstract
OBJECTIVE: Because new modes of action for the treatment of psoriatic arthritis (PsA) are emerging, it is important to understand the use of switching to a second or third antitumor necrosis factor (anti-TNF) agent. This study investigated drug survival and treatment response rates of patients with PsA undergoing second- and third-line anti-TNF therapy. METHODS: Patients with PsA were monitored in a prospective, observational study. Patients who switched anti-TNF therapy once (first-time switchers, n = 217) or twice (second-time switchers, n = 57) between January 2003 and March 2012 were studied. American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) good response at 3 and 6 months, as well as drug survival, were reported and further analyzed using the Cox and logistic regression models. RESULTS: Median age for first-time switchers was 47 years and 42% were men. The corresponding values for second-time switchers were 48 years and 40% men. Three-month ACR20 Lund Efficacy Index (LUNDEX) response was achieved by 47% of first-time and 22% of second-time switchers; ACR50 LUNDEX rates were 21% and 14%, ACR70 LUNDEX rates were 12% and 2%, and EULAR good LUNDEX rates were 26% and 10%, respectively. Median drug survival time for patients switching anti-TNF for the first time was 64 months (95% CI 31-97) compared with 14 months (95% CI 5-23) for second-time switchers. Identified baseline predictor of ACR20 response to second-line treatment was the 28-joint Disease Activity Score values at baseline (OR 1.45, 95% CI 1.01-2.10), while higher Health Assessment Questionnaire scores predicted premature drug withdrawal (HR 1.60, 95% CI 1.03-2.48). CONCLUSION: Response rates of first-time anti-TNF switchers are moderate, while the inferior response rates of second-time switchers suggest other therapeutic options should be considered in this situation.
OBJECTIVE: Because new modes of action for the treatment of psoriatic arthritis (PsA) are emerging, it is important to understand the use of switching to a second or third antitumor necrosis factor (anti-TNF) agent. This study investigated drug survival and treatment response rates of patients with PsA undergoing second- and third-line anti-TNF therapy. METHODS:Patients with PsA were monitored in a prospective, observational study. Patients who switched anti-TNF therapy once (first-time switchers, n = 217) or twice (second-time switchers, n = 57) between January 2003 and March 2012 were studied. American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) good response at 3 and 6 months, as well as drug survival, were reported and further analyzed using the Cox and logistic regression models. RESULTS: Median age for first-time switchers was 47 years and 42% were men. The corresponding values for second-time switchers were 48 years and 40% men. Three-month ACR20 Lund Efficacy Index (LUNDEX) response was achieved by 47% of first-time and 22% of second-time switchers; ACR50 LUNDEX rates were 21% and 14%, ACR70 LUNDEX rates were 12% and 2%, and EULAR good LUNDEX rates were 26% and 10%, respectively. Median drug survival time for patients switching anti-TNF for the first time was 64 months (95% CI 31-97) compared with 14 months (95% CI 5-23) for second-time switchers. Identified baseline predictor of ACR20 response to second-line treatment was the 28-joint Disease Activity Score values at baseline (OR 1.45, 95% CI 1.01-2.10), while higher Health Assessment Questionnaire scores predicted premature drug withdrawal (HR 1.60, 95% CI 1.03-2.48). CONCLUSION: Response rates of first-time anti-TNF switchers are moderate, while the inferior response rates of second-time switchers suggest other therapeutic options should be considered in this situation.
Authors: Philip J Mease; Chitra Karki; Mei Liu; YouFu Li; Bernice Gershenson; Hua Feng; Peter Hur; Jeffrey D Greenberg Journal: RMD Open Date: 2019-04-24
Authors: Manuel José Moreno-Ramos; Carlos Sanchez-Piedra; Olga Martínez-González; Carlos Rodríguez-Lozano; Carolina Pérez-Garcia; Mercedes Freire; Cristina Campos; Rafael Cáliz-Caliz; Jerusalem Calvo; Juan María Blanco-Madrigal; Ana Pérez-Gómez; María José Moreno-Martínez; Luis Linares; Fernando Sánchez-Alonso; Carlos Sastré; Isabel Castrejón Journal: Rheumatol Ther Date: 2022-04-25
Authors: Luisa Costa; Carlo Perricone; Maria Sole Chimenti; Antonio Del Puente; Paolo Caso; Rosario Peluso; Paolo Bottiglieri; Raffaele Scarpa; Francesco Caso Journal: Drugs R D Date: 2017-12
Authors: Laure Gossec; Xenofon Baraliakos; Andreas Kerschbaumer; Maarten de Wit; Iain McInnes; Maxime Dougados; Jette Primdahl; Dennis G McGonagle; Daniel Aletaha; Andra Balanescu; Peter V Balint; Heidi Bertheussen; Wolf-Henning Boehncke; Gerd R Burmester; Juan D Canete; Nemanja S Damjanov; Tue Wenzel Kragstrup; Tore K Kvien; Robert B M Landewé; Rik Jozef Urbain Lories; Helena Marzo-Ortega; Denis Poddubnyy; Santiago Andres Rodrigues Manica; Georg Schett; Douglas J Veale; Filip E Van den Bosch; Désirée van der Heijde; Josef S Smolen Journal: Ann Rheum Dis Date: 2020-06 Impact factor: 27.973