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

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dc.authoriddelcoigne, benedicte/0000-0002-2716-5679
dc.authoridNissen, Michael/0000-0002-6326-1764
dc.authoridSantos, Maria Jose/0000-0002-7946-1365
dc.authoridSanchez-Piedra, Carlos/0000-0001-5420-7347
dc.authoridMöller, Burkhard/0000-0001-8769-6167
dc.authoridLove, THorvardur Jon/0000-0002-2680-6120
dc.authoridRelas, Heikki/0000-0001-8065-3930
dc.authorwosidIannone, Florenzo/AIC-3027-2022
dc.authorwosidCodreanu, Catalin O/GWZ-7860-2022
dc.authorwosiddelcoigne, benedicte/L-8611-2019
dc.authorwosidNissen, Michael/AFM-2225-2022
dc.authorwosidSantos, Maria Jose/N-6913-2014
dc.authorwosidSanchez-Piedra, Carlos/HTL-4436-2023
dc.authorwosidRibeiro, Pedro Ávila/KEH-0342-2024
dc.contributor.authorLindstrom, Ulf
dc.contributor.authorDi Giuseppe, Daniela
dc.contributor.authorDelcoigne, Benedicte
dc.contributor.authorGlintborg, Bente
dc.contributor.authorMoller, Burkhard
dc.contributor.authorCiurea, Adrian
dc.contributor.authorPombo-Suarez, Manuel
dc.date.accessioned2024-08-04T20:50:17Z
dc.date.available2024-08-04T20:50:17Z
dc.date.issued2021
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground 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.en_US
dc.description.sponsorshipNovartis; NordForsken_US
dc.description.sponsorshipThis work was supported by Novartis. Novartis had no influence on the data collection, statistical analyses, manuscript preparation or decision to submit. The work was also supported by NordForsk.en_US
dc.identifier.doi10.1136/annrheumdis-2021-220097
dc.identifier.endpage1418en_US
dc.identifier.issn0003-4967
dc.identifier.issn1468-2060
dc.identifier.issue11en_US
dc.identifier.pmid34083206en_US
dc.identifier.scopus2-s2.0-85107521561en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage1410en_US
dc.identifier.urihttps://doi.org/10.1136/annrheumdis-2021-220097
dc.identifier.urihttps://hdl.handle.net/11616/99976
dc.identifier.volume80en_US
dc.identifier.wosWOS:000708996500024en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherBmj Publishing Groupen_US
dc.relation.ispartofAnnals of The Rheumatic Diseasesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectarthritisen_US
dc.subjectpsoriaticen_US
dc.subjecttumour necrosis factor inhibitorsen_US
dc.subjectmethotrexateen_US
dc.titleEffectiveness 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 collaborationen_US
dc.typeArticleen_US

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