Impact of discordance between patient's and evaluator's global assessment on treatment outcomes in 14 868 patients with spondyloarthritis
Language English Country Great Britain, England Media print
Document type Journal Article, Observational Study, Research Support, Non-U.S. Gov't
PubMed
31960053
DOI
10.1093/rheumatology/kez656
PII: 5710705
Knihovny.cz E-resources
- Keywords
- TNF inhibitors, axial spondyloarthritis, psoriatic arthritis, treatment outcomes,
- MeSH
- Adult MeSH
- Outcome Assessment, Health Care statistics & numerical data MeSH
- Remission Induction MeSH
- Tumor Necrosis Factor Inhibitors therapeutic use MeSH
- Kaplan-Meier Estimate MeSH
- Middle Aged MeSH
- Humans MeSH
- Logistic Models MeSH
- Longitudinal Studies MeSH
- Patient Acceptance of Health Care statistics & numerical data MeSH
- Proportional Hazards Models MeSH
- Arthritis, Psoriatic drug therapy MeSH
- Registries MeSH
- Spondylarthritis drug therapy MeSH
- Severity of Illness Index * MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Tumor Necrosis Factor Inhibitors MeSH
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
Clinical Epidemiology Division Department of Medicine Solna Karolinska Institutet Stockholm Sweden
Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
Department of Rheumatology Aarhus University Hospital Aarhus Denmark
Department of Rheumatology Diakonhjemmet Hospital Oslo Norway
Department of Rheumatology Geneva University Hospital Geneva Switzerland
Department of Rheumatology University Hospital Zurich Zurich Switzerland
Division of Rheumatology Department of Medicine Hospital of Southern Norway Trust Kristiansand
GISEA Registry Rheumatology Unit DETO University of Bari Italy
Inflammation Center Department of Rheumatology Helsinki University Hospital Helsinki Finland
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
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