Retention rates and identification of factors associated with anti-TNFα, anti-IL17, and anti-IL12/23R agents discontinuation in psoriatic arthritis patients: results from a real-world clinical setting.


Journal

Clinical rheumatology
ISSN: 1434-9949
Titre abrégé: Clin Rheumatol
Pays: Germany
ID NLM: 8211469

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 02 09 2019
accepted: 05 03 2020
revised: 12 02 2020
pubmed: 20 3 2020
medline: 15 5 2021
entrez: 20 3 2020
Statut: ppublish

Résumé

Biologic disease-modifying antirheumatic drugs (bDMARDs) play a pivotal role in the treatment of psoriatic arthritis (PsA). Despite this, their discontinuation due to inefficacy or adverse events is often observed. The aims of this study are to describe retention rates and treatment trends of anti-TNFα, anti-IL17, and anti-IL12/23R agents in patients with PsA and to identify factors associated with bDMARDs discontinuation in a real-world clinical setting. A retrospective cohort study based on the analysis of the three Italian prescription cohorts of patients with PsA has been performed. Survival analysis was performed using Kaplan-Meier curves and Cox proportional-hazards model. During the follow up, which lasted 25.5 (12-60) months, 68 patients discontinued a bDMARD: 13 for primary failure, 12 for secondary failure, 15 for adverse events, 5 for remission, 12 because of lost at follow-up, and 11 for other causes. Cox proportional-hazards demonstrated that a shorter disease duration (HR 0.994991, 95% CI 0.9910336-0.9989647, p = 0.014) and first-line bDMARD (HR 0.5090986, 95% CI 0.3073519-0.8432722, p = 0.009) have a protective role on bDMARD retention rate, while the multivariable analysis failed in demonstrating an independent protective role of male sex on drug retention rate (p = 0.083). No significant differences in retention rate have been found regarding biologic drugs, combination therapy or monotherapy, and class of bDMARD (anti-TNFα or anti-pIL12/23R and anti-IL-17). This study shows that a shorter disease duration and treatment with a first-line bDMARD are predictors of bDMARDs retention rate, further highlighting the importance of early diagnosis of PsA. Key Points • No significant difference in retention among patients treated with anti-IL17A, anti-IL12/23R, and anti-TNFα agents has been demonstrated. • A shorter disease duration and first-line bDMARD treatment are associated with persistence in biologic treatment.

Identifiants

pubmed: 32189149
doi: 10.1007/s10067-020-05027-1
pii: 10.1007/s10067-020-05027-1
doi:

Substances chimiques

Antirheumatic Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2663-2670

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Auteurs

Luca Navarini (L)

Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy. l.navarini@unicampus.it.

Luisa Costa (L)

Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy.

Marco Tasso (M)

Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy.

Maria Sole Chimenti (MS)

Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy.

Damiano Currado (D)

Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.

Giulia Lavinia Fonti (GL)

Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy.

Massimo Ciccozzi (M)

Unit of Clinical Laboratory Science, Department of Medicine, Campus Bio-Medico of Rome University, Rome, Italy.

Domenico Paolo Emanuele Margiotta (DPE)

Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.

Carolina Benigno (C)

Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy.

Erica De Martino (E)

Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy.

Roberto Perricone (R)

Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy.

Antonella Afeltra (A)

Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.

Raffaele Scarpa (R)

Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy.

Francesco Caso (F)

Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy.

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