Distinct long-term disease activity trajectories differentiate early on treatment with etanercept in both rheumatoid arthritis and spondylarthritis patients: a prospective cohort study.

Axial spondyloarthritis Disease activity trajectories Drug survival Etanercept Psoriatic arthritis Rheumatoid arthritis Tumor necrosis factor inhibitor

Journal

Rheumatology international
ISSN: 1437-160X
Titre abrégé: Rheumatol Int
Pays: Germany
ID NLM: 8206885

Informations de publication

Date de publication:
10 Oct 2023
Historique:
received: 27 06 2023
accepted: 01 09 2023
medline: 10 10 2023
pubmed: 10 10 2023
entrez: 10 10 2023
Statut: aheadofprint

Résumé

To characterize disease activity trajectories and compare long-term drug retention between rheumatoid (RA) and spondylarthritis (SpA) patients initiating tumor necrosis factor inhibitor (TNFi) treatment (etanercept). Prospective observational study of RA, axial (AxSpA) and peripheral SpA (PerSpA) patients initiating etanercept during 2004-2020. Kaplan-Meier plots were used for drug retention comparisons and multivariable Cox regression models for predictors of discontinuation. Long-term disease activity trajectories were identified by latent class growth models using DAS28-ESR or ASDAS-CRP as outcome for RA and AxSpA respectively. We assessed 711 patients (450 RA, 178 AxSpA and 83 PerSpA) with a median (IQR) follow-up of 12 (5-32) months. At 5 years, 22%, 30% and 21% of RA, AxSpA and PerSpA patients, respectively, remained on therapy. Etanercept discontinuation was independent of the diagnosis and was predicted by gender and obesity in both RA and SpA groups. Four disease activity (DA) trajectories were identified from 6th month of treatment in both RA and AxSpA. RA patients in remission-low DA groups (33.7%) were younger, had shorter disease duration, fewer comorbidities and lower baseline disease activity compared to moderate (40.6%) & high DA (25.7%) groups. In AxSpA 74% were in inactive-low DA and they were more often males, non-obese and had lower number of comorbidities compared to higher ASDAS-CRP trajectories. In RA and AxSpA patients, disease activity trajectories revealed heterogeneity of TNFi treatment responses and prognosis. Male gender, lower baseline disease activity and fewer comorbidities, characterize a favourable outcome in terms of disease burden accrual and TNFi survival.

Identifiants

pubmed: 37815625
doi: 10.1007/s00296-023-05455-7
pii: 10.1007/s00296-023-05455-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Pfizer Pharmaceuticals
ID : 55999165

Informations de copyright

© 2023. The Author(s).

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Auteurs

Irini Flouri (I)

Rheumatology, Clinical Immunology and Allergy Department, Medical School, University of Crete, Heraklion, Greece.

Panagiota Goutakoli (P)

Laboratory of Rheumatology, Autoimmunity and Inflammation, Medical School, University of Crete, Heraklion, Greece and Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology Hellas (FORTH), Heraklion, Greece.

Argyro Repa (A)

Rheumatology, Clinical Immunology and Allergy Department, Medical School, University of Crete, Heraklion, Greece.

Antonios Bertsias (A)

Rheumatology, Clinical Immunology and Allergy Department, Medical School, University of Crete, Heraklion, Greece.

Nestor Avgoustidis (N)

Rheumatology, Clinical Immunology and Allergy Department, Medical School, University of Crete, Heraklion, Greece.

Anastasios Eskitzis (A)

Rheumatology, Clinical Immunology and Allergy Department, Medical School, University of Crete, Heraklion, Greece.

Sofia Pitsigavdaki (S)

Rheumatology, Clinical Immunology and Allergy Department, Medical School, University of Crete, Heraklion, Greece.

Eleni Kalogiannaki (E)

Rheumatology, Clinical Immunology and Allergy Department, Medical School, University of Crete, Heraklion, Greece.

Maria Terizaki (M)

Rheumatology, Clinical Immunology and Allergy Department, Medical School, University of Crete, Heraklion, Greece.

George Bertsias (G)

Laboratory of Rheumatology, Autoimmunity and Inflammation, Medical School, University of Crete, Heraklion, Greece and Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology Hellas (FORTH), Heraklion, Greece.

Prodromos Sidiropoulos (P)

Laboratory of Rheumatology, Autoimmunity and Inflammation, Medical School, University of Crete, Heraklion, Greece and Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology Hellas (FORTH), Heraklion, Greece. sidiropp@uoc.gr.

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