Florenzo Iannone1, Simona Lopriore2, Romano Bucci2, Giuseppe Lopalco2, Angela Chialà2, Luca Cantarini2, Giovanni Lapadula2. 1. From the Rheumatology Unit, Medical School, University of Bari, Bari; the Rheumatology Unit, Ospedali Riuniti di Foggia, Foggia; and the Department of Rheumatology, Policlinico Le Scotte, University of Siena, Siena, Italy.F. Iannone, MD, PhD, Associate Professor of Rheumatology, Rheumatology Unit, Medical School, University of Bari; S. Lopriore, MD, Research Assistant of Rheumatology, Rheumatology Unit, Medical School, University of Bari; R. Bucci, MD, Consultant of Rheumatology, Rheumatology Unit, Ospedali Riuniti di Foggia; G. Lopalco, MD, Consultant of Rheumatology, Rheumatology Unit, Medical School, University of Bari; A. Chialà, MD, Consultant of Rheumatology, Rheumatology Unit, Medical School, University of Bari; L. Cantarini, MD, Senior Lecturer of Rheumatology, Policlinico Le Scotte, University of Siena; G. Lapadula, MD, Rheumatology Unit, Medical School, University of Bari. florenzo.iannone@uniba.it. 2. From the Rheumatology Unit, Medical School, University of Bari, Bari; the Rheumatology Unit, Ospedali Riuniti di Foggia, Foggia; and the Department of Rheumatology, Policlinico Le Scotte, University of Siena, Siena, Italy.F. Iannone, MD, PhD, Associate Professor of Rheumatology, Rheumatology Unit, Medical School, University of Bari; S. Lopriore, MD, Research Assistant of Rheumatology, Rheumatology Unit, Medical School, University of Bari; R. Bucci, MD, Consultant of Rheumatology, Rheumatology Unit, Ospedali Riuniti di Foggia; G. Lopalco, MD, Consultant of Rheumatology, Rheumatology Unit, Medical School, University of Bari; A. Chialà, MD, Consultant of Rheumatology, Rheumatology Unit, Medical School, University of Bari; L. Cantarini, MD, Senior Lecturer of Rheumatology, Policlinico Le Scotte, University of Siena; G. Lapadula, MD, Rheumatology Unit, Medical School, University of Bari.
Abstract
OBJECTIVE: An observational study to evaluate the longterm clinical outcomes of adalimumab (ADA), etanercept (ETN), and infliximab (IFX) in patients with psoriatic arthritis (PsA), in real-world settings. METHODS: From a prospective cohort we studied 420 biologic-naive patients with PsA who had peripheral arthritis and were beginning a treatment with ADA, ETN, or IFX. Drug survival was evaluated by Kaplan-Meier life analysis, and baseline predictors of drug discontinuation were assessed by Cox regression analysis. The frequency of concomitant glucocorticoids and the daily mean dosage were compared by chi-square test and ANOVA repeated measures across 4 years. RESULTS: After 4 years the overall survival of the first anti-tumor necrosis factor-α (anti-TNF) was 51.0%, but significantly higher for ETN (58.9%) than ADA (43.9%) or IFX (44.0%; p = 0.003). Patients taking ETN also had the lowest HR of drug discontinuation (HR 0.57, 95% CI 0.34-0.93, p = 0.02). The strongest predictor of drug interruption was female sex (HR 2.02, 95% CI 1.28-3.20, p = 0.002). The disease duration was inversely correlated with drug discontinuation (HR 0.96, 95% CI 0.93-0.99, p = 0.02). The average daily dose of prednisone significantly decreased from baseline: 5.6 ± 2.5 to 4.7 ± 1.9 at 1 year (p = 0.01) to 4.0 ± 1.8 at 4 years (p = 0.001). Additionally, compared to baseline (49.6%), a significant reduction of patients taking glucocorticoids was detected at 2 years (36.5%, p < 0.05), 3 years (29.9%, p < 0.01), and 4 years (22.6%, p < 0.01). CONCLUSION: In real-world settings, TNF inhibitors showed a high rate of drug survival at 4 years. Further, the need for glucocorticoids for controlling active PsA was lowered with time.
OBJECTIVE: An observational study to evaluate the longterm clinical outcomes of adalimumab (ADA), etanercept (ETN), and infliximab (IFX) in patients with psoriatic arthritis (PsA), in real-world settings. METHODS: From a prospective cohort we studied 420 biologic-naive patients with PsA who had peripheral arthritis and were beginning a treatment with ADA, ETN, or IFX. Drug survival was evaluated by Kaplan-Meier life analysis, and baseline predictors of drug discontinuation were assessed by Cox regression analysis. The frequency of concomitant glucocorticoids and the daily mean dosage were compared by chi-square test and ANOVA repeated measures across 4 years. RESULTS: After 4 years the overall survival of the first anti-tumornecrosis factor-α (anti-TNF) was 51.0%, but significantly higher for ETN (58.9%) than ADA (43.9%) or IFX (44.0%; p = 0.003). Patients taking ETN also had the lowest HR of drug discontinuation (HR 0.57, 95% CI 0.34-0.93, p = 0.02). The strongest predictor of drug interruption was female sex (HR 2.02, 95% CI 1.28-3.20, p = 0.002). The disease duration was inversely correlated with drug discontinuation (HR 0.96, 95% CI 0.93-0.99, p = 0.02). The average daily dose of prednisone significantly decreased from baseline: 5.6 ± 2.5 to 4.7 ± 1.9 at 1 year (p = 0.01) to 4.0 ± 1.8 at 4 years (p = 0.001). Additionally, compared to baseline (49.6%), a significant reduction of patients taking glucocorticoids was detected at 2 years (36.5%, p < 0.05), 3 years (29.9%, p < 0.01), and 4 years (22.6%, p < 0.01). CONCLUSION: In real-world settings, TNF inhibitors showed a high rate of drug survival at 4 years. Further, the need for glucocorticoids for controlling active PsA was lowered with time.
Authors: Dietlinde Wolf; Henry Barreras; Cameron S Bader; Sabrina Copsel; Casey O Lightbourn; Brent J Pfeiffer; Norman H Altman; Eckhard R Podack; Krishna V Komanduri; Robert B Levy Journal: Biol Blood Marrow Transplant Date: 2017-02-20 Impact factor: 5.742
Authors: Philip J Mease; Neil A Accortt; Sabrina Rebello; Carol J Etzel; Ryan W Harrison; Girish A Aras; Mahdi M F Gharaibeh; Jeffrey D Greenberg; David H Collier Journal: Rheumatol Int Date: 2019-07-18 Impact factor: 2.631
Authors: Karen Minde Fagerli; Lianne Kearsley-Fleet; Kath D Watson; Jon Packham; Bsrbr-Ra Contributors Group; Deborah P M Symmons; Kimme L Hyrich Journal: RMD Open Date: 2018-01-07