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One-Third of European Patients With Axial Spondyloarthritis Reach Pain Remission With Routine Care Tumor Necrosis Factor Inhibitor Treatment
LM. Ørnbjerg, K. Rugbjerg, S. Georgiadis, SH. Rasmussen, U. Lindström, K. Pavelka, N. Yilmaz, EG. Favalli, MJ. Nissen, B. Michelsen, E. Vieira-Sousa, GT. Jones, R. Ionescu, H. Relas, C. Sanchez-Piedra, M. Tomšič, AJ. Geirsson, I. van der...
Language English Country Canada
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
36455943
DOI
10.3899/jrheum.220459
Knihovny.cz E-resources
- MeSH
- Spondylitis, Ankylosing * drug therapy MeSH
- Pain MeSH
- Tumor Necrosis Factor Inhibitors therapeutic use MeSH
- Humans MeSH
- Non-Radiographic Axial Spondyloarthritis * MeSH
- Spondylarthritis * drug therapy MeSH
- Tumor Necrosis Factor-alpha MeSH
- Fatigue drug therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVE: To investigate the distribution of patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA) initiating a tumor necrosis factor inhibitor (TNFi), to assess the proportion reaching PRO "remission" across registries and treatment series, and to compare patients registered to fulfill the modified New York (mNY) criteria for ankylosing spondylitis (AS) vs patients with nonradiographic axSpA (nr-axSpA). METHODS: Fifteen European registries contributed PRO scores for pain, fatigue, patient global assessment (PtGA), Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Health Assessment Questionnaire (HAQ) from 19,498 patients with axSpA. Changes in PROs and PRO remission rates (definitions: ≤ 20 mm for pain, fatigue, PtGA, BASDAI, and BASFI; ≤ 0.5 for HAQ) were calculated at 6, 12, and 24 months of treatment. RESULTS: Heterogeneity in baseline characteristics and outcomes between registries were observed. In pooled data, 6 months after the start of a first TNFi, pain score was reduced by approximately 60% (median at baseline/6/12/24 months: 65/25/20/20 mm) in patients on treatment. Similar patterns were observed for fatigue (68/32/30/25 mm), PtGA (66/29/21/20 mm), BASDAI (58/26/21/19 mm), BASFI (46/20/16/16 mm), and HAQ (0.8/0.4/0.2/0.2). Patients with AS (n = 3281) had a slightly better response than patients with nr-axSpA (n = 993). The Lund Efficacy Index (LUNDEX)-adjusted remission rates at 6 months for pain/fatigue/PtGA/BASDAI/BASFI/HAQ were 39%/30%/38%/34%/35%/48% for the AS cohort and 30%/21%/26%/24%/33%/47% for the nr-axSpA cohort. Better PRO responses were seen with a first TNFi compared to a second and third TNFi. CONCLUSION: Patients with axSpA starting a TNFi achieved high PRO remission rates, most pronounced in those fulfilling the mNY criteria and for the first TNFi.
A J Geirsson MD Department of Rheumatology University Hospital Reykjavik Iceland
C Sanchez Piedra MD PhD Research Unit Spanish Society of Rheumatology Madrid Spain
E G Favalli MD PhD Division of Clinical Rheumatology ASST Gaetano Pini CTO Institute Milan Italy
F Iannone MD PhD Rheumatology Unit DETO University of Bari Italy
H Direskeneli MD Department of Rheumatology Marmara University School of Medicine Istanbul Turkey
J Askling MD PhD Department of Medicine Solna Karolinska Institutet Stockholm Sweden
K M Fagerli MD PhD Department of Rheumatology and Research Diakonhjemmet Hospital Oslo Norway
M J Nissen MD PhD Department of Rheumatology Geneva University Hospital Geneva Switzerland
M J Santos MD PhD Department of Rheumatology Hospital Garcia de Orta Almada Portugal
N Yilmaz MD Department of Rheumatology Demiroglu Bilim University Istanbul Turkey
R Ionescu MD PhD Carol Davila University of Medicine and Pharmacy Bucharest Romania
References provided by Crossref.org
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- $a OBJECTIVE: To investigate the distribution of patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA) initiating a tumor necrosis factor inhibitor (TNFi), to assess the proportion reaching PRO "remission" across registries and treatment series, and to compare patients registered to fulfill the modified New York (mNY) criteria for ankylosing spondylitis (AS) vs patients with nonradiographic axSpA (nr-axSpA). METHODS: Fifteen European registries contributed PRO scores for pain, fatigue, patient global assessment (PtGA), Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Health Assessment Questionnaire (HAQ) from 19,498 patients with axSpA. Changes in PROs and PRO remission rates (definitions: ≤ 20 mm for pain, fatigue, PtGA, BASDAI, and BASFI; ≤ 0.5 for HAQ) were calculated at 6, 12, and 24 months of treatment. RESULTS: Heterogeneity in baseline characteristics and outcomes between registries were observed. In pooled data, 6 months after the start of a first TNFi, pain score was reduced by approximately 60% (median at baseline/6/12/24 months: 65/25/20/20 mm) in patients on treatment. Similar patterns were observed for fatigue (68/32/30/25 mm), PtGA (66/29/21/20 mm), BASDAI (58/26/21/19 mm), BASFI (46/20/16/16 mm), and HAQ (0.8/0.4/0.2/0.2). Patients with AS (n = 3281) had a slightly better response than patients with nr-axSpA (n = 993). The Lund Efficacy Index (LUNDEX)-adjusted remission rates at 6 months for pain/fatigue/PtGA/BASDAI/BASFI/HAQ were 39%/30%/38%/34%/35%/48% for the AS cohort and 30%/21%/26%/24%/33%/47% for the nr-axSpA cohort. Better PRO responses were seen with a first TNFi compared to a second and third TNFi. CONCLUSION: Patients with axSpA starting a TNFi achieved high PRO remission rates, most pronounced in those fulfilling the mNY criteria and for the first TNFi.
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