Effectiveness and drug survival of TNF-inhibitors in the treatment of psoriatic arthritis : A prospective cohort study

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Aaltonen , K , Heinonen , A , Joensuu , J , Parmanne , P , Karjalainen , A , Varjolahti-Lehtinen , T , Uutela , T , Puurtinen-Vilkki , M , Arstila , L , Blom , M , Sokka , T & Nordström , D 2017 , ' Effectiveness and drug survival of TNF-inhibitors in the treatment of psoriatic arthritis : A prospective cohort study ' , Seminars in Arthritis and Rheumatism , vol. 46 , no. 6 , pp. 732-739 . https://doi.org/10.1016/j.semarthrit.2016.09.005

Title: Effectiveness and drug survival of TNF-inhibitors in the treatment of psoriatic arthritis : A prospective cohort study
Author: Aaltonen, Kalle; Heinonen, Arto; Joensuu, Jaana; Parmanne, Pinja; Karjalainen, Anna; Varjolahti-Lehtinen, Tuire; Uutela, Toini; Puurtinen-Vilkki, Maija; Arstila, Leena; Blom, Marja; Sokka, Tuulikki; Nordström, Dan
Contributor organization: Faculty of Pharmacy
Division of Pharmacology and Pharmacotherapy
University of Helsinki
Department of Medicine
HUS Internal Medicine and Rehabilitation
Date: 2017-06
Language: eng
Number of pages: 8
Belongs to series: Seminars in Arthritis and Rheumatism
ISSN: 0049-0172
DOI: https://doi.org/10.1016/j.semarthrit.2016.09.005
URI: http://hdl.handle.net/10138/237055
Abstract: Background and objectives: Tumor necrosis factor (TNF)-inhibitors are used to treat psoriatic arthritis (PsA), but only a limited number of observational studies on this subject have been published thus far. The aim of this research was to analyze the effectiveness and drug survival of TNF-inhibitors in the treatment of PsA. Methods: PsA patients identified from the National Register for Biologic Treatment in Finland (ROB-FIN) starting their first, second, or third TNF-inhibitor treatment between 2004 and 2014 were included. Effectiveness was measured using ACR and EULAR response criteria and modeled using ordinal logistic regression. Treatment persistence was analyzed using Kaplan-Meier survival analysis and Cox proportional hazards model. Results: The study comprised 765 patients and 990 TNF-inhibitor treatment courses. EULAR moderate treatment responses at 6 months were achieved by 68% and 37% of the users of the first and the second or the third biologic, respectively. The probabilities of discontinuing the treatment within 12 and 24 months were 20% and 28%, respectively. Adjusted treatment responses to all TNF-inhibitors were similar; however, co-therapy with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) was not associated with better effectiveness. Adalimumab [hazard ratio (HR) = 0.62; 95% confidence interval (CD: 0.44-0.88] was superior to infliximab in drug survival while etanercept (HR = 0.77, 95% CI: 0.55-1.1) and golimumab (HR = 0.75, 95% CI: 0.46-1.2) did not differ from it. Co-medication with csDMARDs did not statistically improve drug survival. Conclusion: All available TNF-inhibitors showed similar treatment responses with or without csDMARDs. Adalimumab was associated with better drug survival when compared to infliximab. (C) 2017 Elsevier Inc. All rights reserved.
Subject: Psoriatic arthritis
Cohort study
Drug survival
Treatment response
3121 General medicine, internal medicine and other clinical medicine
317 Pharmacy
Peer reviewed: Yes
Rights: unspecified
Usage restriction: openAccess
Self-archived version: publishedVersion

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