Alexis Ogdie1,2, J Lynn Palmer3,4, Jeffrey Greenberg3,4, Jeffrey R Curtis3,4, Leslie R Harrold3,4, Daniel H Solomon3,4, Arthur Kavanaugh3,4, Joel M Kremer3,4, Philip J Mease3,4. 1. From the University of Pennsylvania, Philadelphia, Pennsylvania; Corrona Research Foundation; New York University Hospital for Joint Diseases, New York, New York; University of Alabama at Birmingham, Birmingham, Alabama; University of Massachusetts, Worcester; Brigham and Women's Hospital, Boston, Massachusetts; University of California San Diego, San Diego, California; Albany Medical College, Albany, New York; Swedish Medical Center; University of Washington, Seattle, Washington, USA. alexis.ogdie@uphs.upenn.edu. 2. A. Ogdie, MD, MSCE, University of Pennsylvania; J.L. Palmer, PhD, Corrona Research Foundation; J. Greenberg, MD, New York University Hospital for Joint Diseases; J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; L.R. Harrold, MD, MPH, Corrona Research Foundation; D.H. Solomon, MD, MPH, Brigham and Women's Hospital; A. Kavanaugh, MD, University of California at San Diego; J.M. Kremer, MD, Corrona Research Foundation, and Albany Medical College; P.J. Mease, MD, Swedish Medical Center, and University of Washington. alexis.ogdie@uphs.upenn.edu. 3. From the University of Pennsylvania, Philadelphia, Pennsylvania; Corrona Research Foundation; New York University Hospital for Joint Diseases, New York, New York; University of Alabama at Birmingham, Birmingham, Alabama; University of Massachusetts, Worcester; Brigham and Women's Hospital, Boston, Massachusetts; University of California San Diego, San Diego, California; Albany Medical College, Albany, New York; Swedish Medical Center; University of Washington, Seattle, Washington, USA. 4. A. Ogdie, MD, MSCE, University of Pennsylvania; J.L. Palmer, PhD, Corrona Research Foundation; J. Greenberg, MD, New York University Hospital for Joint Diseases; J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; L.R. Harrold, MD, MPH, Corrona Research Foundation; D.H. Solomon, MD, MPH, Brigham and Women's Hospital; A. Kavanaugh, MD, University of California at San Diego; J.M. Kremer, MD, Corrona Research Foundation, and Albany Medical College; P.J. Mease, MD, Swedish Medical Center, and University of Washington.
Abstract
OBJECTIVE: To examine predictors of remission among patients with psoriatic arthritis (PsA) initiating a tumor necrosis factor (TNF) inhibitor. METHODS: Patients with PsA enrolled in the Corrona Registry between 2005 and 2013 were followed from initiation of a TNF inhibitor (TNFi; etanercept, adalimumab, infliximab, certolizumab, or golimumab) to the visit closest to 12 months. Additional inclusion criteria included 3 tender or 3 swollen joints. Outcomes of interest were Clinical Disease Activity Index (CDAI) ≤ 2.8 (remission), low disease activity (LDA; CDAI ≤ 10), change in the modified Health Assessment Questionnaire (mHAQ) ≥ 0.35 and achievement of mHAQ < 0.30. Predictors were measured on or before TNFi initiation. Covariates significant in univariable logistic regression models and ≤ 5% missing values were included in a multivariable model and removed individually until all remaining variables were significant (p < 0.05). RESULTS: Among 1832 TNFi initiations, 774 initiations (624 patients) met inclusion criteria. Median age at initiation was 52 years [interquartile range (IQR) 44-60], 56% were female, median PsA duration was 4 years (IQR 2-11), and median CDAI at baseline was 20 (IQR 14.5-28). Remission was achieved by 14% and LDA (or remission) by 37%. Achieving remission was positively associated with college education (OR 1.88, 95% CI 1.11-3.19) but negatively associated with female sex (0.62, 95% CI 0.40-0.97), obese body mass index (0.51, 95% CI 0.32-0.81), hypertension (0.55, 95% CI 0.32-0.95), previous biologic use (0.41, 95% CI 0.26-0.65), and baseline pain (0.80 per 10 mm visual analog scale, 95% CI 0.73-0.87). Predictors for LDA, mHAQ < 0.30, and mHAQ change were similar. CONCLUSION: Few patients with PsA in a US-based registry achieved remission by CDAI criteria. Female sex, obesity, comorbidities, and education influence achievement of remission on a TNFi.
OBJECTIVE: To examine predictors of remission among patients with psoriatic arthritis (PsA) initiating a tumor necrosis factor (TNF) inhibitor. METHODS:Patients with PsA enrolled in the Corrona Registry between 2005 and 2013 were followed from initiation of a TNF inhibitor (TNFi; etanercept, adalimumab, infliximab, certolizumab, or golimumab) to the visit closest to 12 months. Additional inclusion criteria included 3 tender or 3 swollen joints. Outcomes of interest were Clinical Disease Activity Index (CDAI) ≤ 2.8 (remission), low disease activity (LDA; CDAI ≤ 10), change in the modified Health Assessment Questionnaire (mHAQ) ≥ 0.35 and achievement of mHAQ < 0.30. Predictors were measured on or before TNFi initiation. Covariates significant in univariable logistic regression models and ≤ 5% missing values were included in a multivariable model and removed individually until all remaining variables were significant (p < 0.05). RESULTS: Among 1832 TNFi initiations, 774 initiations (624 patients) met inclusion criteria. Median age at initiation was 52 years [interquartile range (IQR) 44-60], 56% were female, median PsA duration was 4 years (IQR 2-11), and median CDAI at baseline was 20 (IQR 14.5-28). Remission was achieved by 14% and LDA (or remission) by 37%. Achieving remission was positively associated with college education (OR 1.88, 95% CI 1.11-3.19) but negatively associated with female sex (0.62, 95% CI 0.40-0.97), obese body mass index (0.51, 95% CI 0.32-0.81), hypertension (0.55, 95% CI 0.32-0.95), previous biologic use (0.41, 95% CI 0.26-0.65), and baseline pain (0.80 per 10 mm visual analog scale, 95% CI 0.73-0.87). Predictors for LDA, mHAQ < 0.30, and mHAQ change were similar. CONCLUSION: Few patients with PsA in a US-based registry achieved remission by CDAI criteria. Female sex, obesity, comorbidities, and education influence achievement of remission on a TNFi.
Authors: Fabiola Atzeni; Elisabetta Gerratana; Ignazio Francesco Masala; Sara Bongiovanni; Piercarlo Sarzi-Puttini; Javier Rodríguez-Carrio Journal: Front Med (Lausanne) Date: 2021-08-30
Authors: Amir Haddad; Tal Gazitt; Ilan Feldhamer; Joy Feld; Arnon Dov Cohen; Idit Lavi; Faten Tatour; Irena Bergman; Devy Zisman Journal: Arthritis Res Ther Date: 2021-01-29 Impact factor: 5.156
Authors: Eva Klingberg; Sofia Björkman; Björn Eliasson; Ingrid Larsson; Annelie Bilberg Journal: Arthritis Res Ther Date: 2020-10-22 Impact factor: 5.156