One-Third of European Patients With Axial Spondyloarthritis Reach Pain Remission With Routine Care Tumor Necrosis Factor Inhibitor Treatment.

Humans Spondylitis, Ankylosing / drug therapy Spondylarthritis / drug therapy Tumor Necrosis Factor Inhibitors / therapeutic use Non-Radiographic Axial Spondyloarthritis Treatment Outcome Pain Fatigue / drug therapy Tumor Necrosis Factor-alpha
axial spondyloarthritis patient-reported outcome measures tumor necrosis factor inhibitors

Journal

The Journal of rheumatology
ISSN: 0315-162X
Titre abrégé: J Rheumatol
Pays: Canada
ID NLM: 7501984

Informations de publication

Date de publication:
08 2023
Historique:
accepted: 13 10 2022
medline: 3 8 2023
pubmed: 2 12 2022
entrez: 1 12 2022
Statut: ppublish

Résumé

To investigate the distribution of patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA) initiating a tumor necrosis factor inhibitor (TNFi), to assess the proportion reaching PRO "remission" across registries and treatment series, and to compare patients registered to fulfill the modified New York (mNY) criteria for ankylosing spondylitis (AS) vs patients with nonradiographic axSpA (nr-axSpA). Fifteen European registries contributed PRO scores for pain, fatigue, patient global assessment (PtGA), Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Health Assessment Questionnaire (HAQ) from 19,498 patients with axSpA. Changes in PROs and PRO remission rates (definitions: ≤ 20 mm for pain, fatigue, PtGA, BASDAI, and BASFI; ≤ 0.5 for HAQ) were calculated at 6, 12, and 24 months of treatment. Heterogeneity in baseline characteristics and outcomes between registries were observed. In pooled data, 6 months after the start of a first TNFi, pain score was reduced by approximately 60% (median at baseline/6/12/24 months: 65/25/20/20 mm) in patients on treatment. Similar patterns were observed for fatigue (68/32/30/25 mm), PtGA (66/29/21/20 mm), BASDAI (58/26/21/19 mm), BASFI (46/20/16/16 mm), and HAQ (0.8/0.4/0.2/0.2). Patients with AS (n = 3281) had a slightly better response than patients with nr-axSpA (n = 993). The Lund Efficacy Index (LUNDEX)-adjusted remission rates at 6 months for pain/fatigue/PtGA/BASDAI/BASFI/HAQ were 39%/30%/38%/34%/35%/48% for the AS cohort and 30%/21%/26%/24%/33%/47% for the nr-axSpA cohort. Better PRO responses were seen with a first TNFi compared to a second and third TNFi. Patients with axSpA starting a TNFi achieved high PRO remission rates, most pronounced in those fulfilling the mNY criteria and for the first TNFi.

Identifiants

DOI: 10.3899/jrheum.220459 PMID: 36455943
pubmed: 36455943
pii: jrheum.220459
doi: 10.3899/jrheum.220459
doi:

Substances chimiques

Tumor Necrosis Factor Inhibitors 0
Tumor Necrosis Factor-alpha 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1009-1019

Informations de copyright

Copyright © 2023 by the Journal of Rheumatology.

Auteurs

Lykke Midtbøll Ørnbjerg (LM)

L.M. Ørnbjerg, MD, PhD, K. Rugbjerg, MSc, PhD, S. Georgiadis, PhD, S.H. Rasmussen, PhD, Copenhagen Center for Arthritis Research (COPECARE), Centre for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital, Glostrup, Denmark; lykke.midtboell.oernbjerg@regionh.dk.
ORCID: 0000-0002-7832-6831

Kathrine Rugbjerg (K)

L.M. Ørnbjerg, MD, PhD, K. Rugbjerg, MSc, PhD, S. Georgiadis, PhD, S.H. Rasmussen, PhD, Copenhagen Center for Arthritis Research (COPECARE), Centre for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital, Glostrup, Denmark.
ORCID: 0000-0001-7854-1075

Stylianos Georgiadis (S)

L.M. Ørnbjerg, MD, PhD, K. Rugbjerg, MSc, PhD, S. Georgiadis, PhD, S.H. Rasmussen, PhD, Copenhagen Center for Arthritis Research (COPECARE), Centre for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital, Glostrup, Denmark.
ORCID: 0000-0003-3485-9457

Simon Horskjær Rasmussen (SH)

L.M. Ørnbjerg, MD, PhD, K. Rugbjerg, MSc, PhD, S. Georgiadis, PhD, S.H. Rasmussen, PhD, Copenhagen Center for Arthritis Research (COPECARE), Centre for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital, Glostrup, Denmark.
ORCID: 0000-0001-6928-277X

Ulf Lindström (U)

U. Lindström, MD, PhD, Department of Rheumatology and Inflammation Research, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
ORCID: 0000-0002-2250-9348

Karel Pavelka (K)

K. Pavelka, MD, PhD, Institute of Rheumatology, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
ORCID: 0000-0003-1952-8422

Neslihan Yilmaz (N)

N. Yilmaz, MD, Department of Rheumatology, Demiroglu Bilim University, Istanbul, Turkey.
ORCID: 0000-0002-8574-5567

Ennio Giulio Favalli (EG)

E.G. Favalli, MD, PhD, Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, Italy.
ORCID: 0000-0003-1471-6467

Michael J Nissen (MJ)

M.J. Nissen, MD, PhD, Department of Rheumatology, Geneva University Hospital, Geneva, Switzerland.
ORCID: 0000-0002-6326-1764

Brigitte Michelsen (B)

B. Michelsen, MD, PhD, Department of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway, and Division of Rheumatology, Department of Medicine, Hospital of Southern Norway Trust, Kristiansand, Norway, and COPECARE, Centre for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital, Glostrup, Denmark.
ORCID: 0000-0003-0103-2840

Elsa Vieira-Sousa (E)

E. Vieira-Sousa, MD, Department of Rheumatology, Hospital de Santa Maria, CHULN, Instituto Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
ORCID: 0000-0002-7170-8802

Gareth T Jones (GT)

G.T. Jones, PhD, G.J. Macfarlane, MD, PhD, Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, United Kingdom.
ORCID: 0000-0003-0016-7591

Ruxandra Ionescu (R)

R. Ionescu, MD, PhD, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Heikki Relas (H)

H. Relas, MD, PhD, K. Eklund, MD, PhD, Inflammation Center, Department of Rheumatology, Helsinki University Hospital, Helsinki, Finland.
ORCID: 0000-0001-8065-3930

Carlos Sanchez-Piedra (C)

C. Sanchez-Piedra, MD, PhD, Research Unit, Spanish Society of Rheumatology, Madrid, Spain.
ORCID: 0000-0001-5420-7347

Matija Tomšič (M)

M. Tomšič, MD, PhD, Z. Rotar, MD, PhD, Department of Rheumatology, University Medical Centre Ljubljana, and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
ORCID: 0000-0002-4507-9010

Arni Jon Geirsson (AJ)

A.J. Geirsson, MD, Department of Rheumatology, University Hospital, Reykjavik, Iceland.

Irene van der Horst-Bruinsma (I)

I. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands.
ORCID: 0000-0002-8086-9915

Johan Askling (J)

J. Askling, MD, PhD, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
ORCID: 0000-0003-0433-0616

Anne Gitte Loft (AG)

A.G. Loft, MD, PhD, Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
ORCID: 0000-0001-6374-841X

Lucie Nekvindova (L)

L. Nekvindova, MD, PhD, Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, and Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic.
ORCID: 0000-0002-8866-2310

Haner Direskeneli (H)

H. Direskeneli, MD, Department of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey.
ORCID: 0000-0003-2598-5806

Florenzo Iannone (F)

F. Iannone, MD, PhD, Rheumatology Unit, DETO, University of Bari, Italy.
ORCID: 0000-0003-0474-5344

Adrian Ciurea (A)

A. Ciurea, MD, Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
ORCID: 0000-0002-7870-7132

Karen Minde Fagerli (KM)

K.M. Fagerli, MD, PhD, Department of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway.
ORCID: 0000-0002-0327-7860

Maria José Santos (MJ)

M.J. Santos, MD, PhD, Department of Rheumatology, Hospital Garcia de Orta, Almada, Portugal.
ORCID: 0000-0002-7946-1365

Gary J Macfarlane (GJ)

G.T. Jones, PhD, G.J. Macfarlane, MD, PhD, Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, United Kingdom.
ORCID: 0000-0003-2322-3314

Catalin Codreanu (C)

C. Codreanu, MD, PhD, Center for Rheumatic Diseases, University of Medicine and Pharmacy, Bucharest, Romania.

Kari Eklund (K)

H. Relas, MD, PhD, K. Eklund, MD, PhD, Inflammation Center, Department of Rheumatology, Helsinki University Hospital, Helsinki, Finland.
ORCID: 0000-0002-5870-4663

Manuel Pombo-Suarez (M)

M. Pombo-Suarez, MD, PhD, Rheumatology Service, Hospital Clinico Universitario, Santiago de Compostela, Spain.
ORCID: 0000-0002-2524-4883

Ziga Rotar (Z)

M. Tomšič, MD, PhD, Z. Rotar, MD, PhD, Department of Rheumatology, University Medical Centre Ljubljana, and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
ORCID: 0000-0002-9323-9189

Bjorn Gudbjornsson (B)

B. Gudbjornsson, MD, PhD, Centre for Rheumatology Research, Landspitali University Hospital, and Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
ORCID: 0000-0003-4631-6505

Tamara Rusman (T)

T. Rusman, MSc, Department of Rheumatology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands.
ORCID: 0000-0001-8628-0119

Mikkel Østergaard (M)

M. Østergaard, MD, PhD, DMSc, M.L. Hetland, MD, PhD, DMSc, COPECARE, Centre for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital, Glostrup, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
ORCID: 0000-0003-3690-467X

Merete Lund Hetland (ML)

M. Østergaard, MD, PhD, DMSc, M.L. Hetland, MD, PhD, DMSc, COPECARE, Centre for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital, Glostrup, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
ORCID: 0000-0003-4229-6818

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