OBJECTIVES: To assess the impact of 'patient's minus evaluator's global assessment of disease activity' (ΔPEG) at treatment initiation on retention and remission rates of TNF inhibitors (TNFi) in psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients across Europe. METHODS: Real-life data from PsA and axSpA patients starting their first TNFi from 11 countries in the European Spondyloarthritis Research Collaboration Network were pooled. Retention rates were compared by Kaplan-Meier analyses with log-rank test and by Cox regression, and remission rates by χ2 test and by logistic regression across quartiles of baseline ΔPEG, separately in female and male PsA and axSpA patients. RESULTS: We included 14 868 spondyloarthritis (5855 PsA, 9013 axSpA) patients. Baseline ΔPEG was negatively associated with 6/12/24-months' TNFi retention rates in female and male PsA and axSpA patients (P <0.001), with 6/12/24-months' BASDAI < 2 (P ≤0.002) and ASDAS < 1.3 (P ≤0.005) in axSpA patients, and with DAS28CRP(4)<2.6 (P ≤0.04) and DAPSA28 ≤ 4 (P ≤0.01), but not DAS28CRP(3)<2.6 (P ≥0.13) in PsA patients, with few exceptions on remission rates. Retention and remission rates were overall lower in female than male patients. CONCLUSION: High baseline patient's compared with evaluator's global assessment was associated with lower 6/12/24-months' remission as well as retention rates of first TNFi in both PsA and axSpA patients. These results highlight the importance of discordance between patient's and evaluator's perspective on disease outcomes.

BioRx si and the Department of Rheumatology University Medical Centre Ljubljana Ljubljana Slovenia

Center of Rheumatic Diseases University of Medicine and Pharmacy 'Carol Davila' Bucharest Romania

Centre for Rheumatology Research University Hospital and Faculty of Medicine University of Iceland Reykjavik Iceland

Clinical Epidemiology Division Department of Medicine Solna Karolinska Institutet Stockholm Sweden

DANBIO Registry Center for Rheumatology and Spine Diseases Centre for Head and Orthopaedics Rigshospitalet Glostrup Denmark

Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

Department of Rheumatology Aarhus University Hospital Aarhus Denmark

Department of Rheumatology and Inflammation Research Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

Department of Rheumatology Diakonhjemmet Hospital Oslo Norway

Department of Rheumatology Geneva University Hospital Geneva Switzerland

Department of Rheumatology University Hospital Zurich Zurich Switzerland

Department Rheumatology and Immunology Center Amsterdam University Medical Centres Location VU University Medical Centre Amsterdam the Netherlands

Division of Rheumatology Department of Medicine Hospital of Southern Norway Trust Kristiansand

Epidemiology Group School of Medicine Medical Science and Nutrition University of Aberdeen Aberdeen UK

EuroSpA Coordinating Center Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Centre for Head and Orthopaedics Rigshospitalet Glostrup Denmark

GISEA Registry Rheumatology Unit DETO University of Bari Italy

Inflammation Center Department of Rheumatology Helsinki University Hospital Helsinki Finland

Institute of Rheumatology and Department of Rheumatology 1st Faculty of Medicine Charles University Prague Czech Republic

Reuma pt Registry and Instituto de Medicina Molecular Faculdade de Medicina Universidade de Lisboa Portugal

Rheumatology Service Hospital Clinico Universitario Santiago de Compostela Spain

ROB FIN Registry Helsinki University and Helsinki University Hospital Helsinki Finland

TURKBIO Registry and Division of Rheumatology School of Medicine Firat University Elazig Turkey

TURKBIO Registry and Division of Rheumatology School of Medicine Kocaeli University Izmit Turkey

University of Iceland Faculty of Medicine Landspitali University Hospital Reykjavik Iceland

Zitelab Aps Copenhagen Denmark

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