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Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration
U. Lindström, D. Di Giuseppe, B. Delcoigne, B. Glintborg, B. Möller, A. Ciurea, M. Pombo-Suarez, C. Sanchez-Piedra, K. Eklund, H. Relas, B. Gudbjornsson, TJ. Love, GT. Jones, C. Codreanu, R. Ionescu, L. Nekvindova, J. Závada, N. Atas, S. Yolbas,...
Jazyk angličtina Země Velká Británie
Typ dokumentu srovnávací studie, časopisecké články, práce podpořená grantem
NLK
ProQuest Central
od 1939-01-01 do 2024-12-31
Health & Medicine (ProQuest)
od 1939-01-01 do 2024-12-31
Family Health Database (ProQuest)
od 1939-01-01 do 2024-12-31
ROAD: Directory of Open Access Scholarly Resources
- MeSH
- adalimumab terapeutické užití MeSH
- antirevmatika terapeutické užití MeSH
- dospělí MeSH
- etanercept terapeutické užití MeSH
- indukce remise MeSH
- infliximab terapeutické užití MeSH
- inhibitory TNF terapeutické užití MeSH
- kombinovaná farmakoterapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- methotrexát terapeutické užití MeSH
- psoriatická artritida farmakoterapie patofyziologie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
BACKGROUND: Comedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) during treatment with tumour necrosis factor inhibitors (TNFi) is extensively used in psoriatic arthritis (PsA), although the additive benefit remains unclear. We aimed to compare treatment outcomes in patients with PsA treated with TNFi and csDMARD comedication versus TNFi monotherapy. METHODS: Patients with PsA from 13 European countries who initiated a first TNFi in 2006-2017 were included. Country-specific comparisons of 1 year TNFi retention were performed by csDMARD comedication status, together with HRs for TNFi discontinuation (comedication vs monotherapy), adjusted for age, sex, calendar year, disease duration and Disease Activity Score with 28 joints (DAS28). Adjusted ORs of clinical remission (based on DAS28) at 12 months were calculated. Between-country heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not significant. Secondary analyses stratified according to TNFi subtype (adalimumab/infliximab/etanercept) and restricted to methotrexate as comedication were performed. RESULTS: In total, 15 332 patients were included (62% comedication, 38% monotherapy). TNFi retention varied across countries, with significant heterogeneity precluding a combined estimate. Comedication was associated with better remission rates, pooled OR 1.25 (1.12-1.41). Methotrexate comedication was associated with improved remission for adalimumab (OR 1.45 (1.23-1.72)) and infliximab (OR 1.55 (1.21-1.98)) and improved retention for infliximab. No effect of comedication was demonstrated for etanercept. CONCLUSION: This large observational study suggests that, as used in clinical practice, csDMARD and TNFi comedication are associated with improved remission rates, and specifically, comedication with methotrexate increases remission rates for both adalimumab and infliximab.
1st Faculty of Medicine Charles University Prague Czech Republic
Centre for Rheumatology Research University Hospital Reykjavik Iceland
Clinical Epidemiology Division Department of Medicine Solna Karolinska Institutet Stockholm Sweden
Department for Rheumatology and Immunology Inselspital University Hospital Bern Bern Switzerland
Department for Science and Research Landspitali University Hospital Reykjavik Iceland
Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
Department of Rheumatology 1st Faculty of Medicine Charles University Prague Czech Republic
Department of Rheumatology and Research Diakonhjemmet Hospital Oslo Norway
Department of Rheumatology Geneva University Hospital Geneva Switzerland
Department of Rheumatology University Hospital Zurich University of Zurich Zurich Switzerland
Department of Rheumatology University Medical Centre Ljubljana Ljubljana Slovenia
Division of Rheumatology Department of Medicine Sorlandet Hospital Kristiansand Norway
Faculty of Medicine University of Iceland Reykjavik Iceland
Faculty of Medicine University of Ljubljana Ljubljana Slovenia
Inflammation Center Department of Rheumatology Helsinki University Hospital Helsinki Finland
Institute of Biostatistics and Analyses Ltd Brno Czech Republic
Institute of Rheumatology Prague Czech Republic
Orton Orthopaedic Hospital Helsinki Finland
Research Unit Spanish Society of Rheumatology Madrid Spain
Reuma pt registry and Department of Rheumatology Hospital Garcia de Orta Almada Portugal
Rheumatology Department Hospital de Santa Maria Lisboa Portugal
Rheumatology Service Hospital Clinico Universitario Santiago de Compostela Spain
Rheumatology Unit DETO University of Bari Bari Italy
Romanian Registry of Rheumatic Diseases University of Medicine and Pharmacy Bucharest Romania
Citace poskytuje Crossref.org
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- $a Lindström, Ulf $u Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ulf.lindstrom@gu.se
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