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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.contributor.authorLindström, Ulf
dc.contributor.authorDi Giuseppe, Daniela
dc.contributor.authorDelcoigne, Bénédicte
dc.contributor.authorGlintborg, Bente
dc.contributor.authorMöller, Burkhard
dc.contributor.authorCiurea, Adrian
dc.contributor.authorPombo-Suarez, Manuel
dc.contributor.authorSanchez-Piedra, Carlos
dc.contributor.authorEklund, Kari
dc.contributor.authorRelas, Heikki
dc.contributor.authorGudbjornsson, Bjorn
dc.contributor.authorLove, Thorvardur Jon
dc.contributor.authorJones, Gareth T.
dc.contributor.authorCodreanu, Catalin
dc.contributor.authorIonescu, Ruxandra
dc.contributor.authorNekvindova, Lucie
dc.contributor.authorZávada, Jakub
dc.contributor.authorAtas, Nuh
dc.contributor.authorYolbas, Servet
dc.contributor.authorFagerli, Karen Minde
dc.contributor.authorMichelsen, Brigitte
dc.contributor.authorRotar, Žiga
dc.contributor.authorTomšič, Matija
dc.contributor.authorIannone, Florenzo
dc.contributor.authorSantos, Maria
dc.contributor.authorAvila-Ribeiro, Pedro
dc.contributor.authorØrnbjerg, Lykke Midtbøll
dc.contributor.authorØstergaard, Mikkel
dc.contributor.authorJacobsson, Lennart T. H.
dc.contributor.authorAskling, Johan
dc.contributor.authorNissen, Michael J.
dc.date.accessioned2021-06-17T14:56:24Z
dc.date.available2021-06-17T14:56:24Z
dc.date.issued2021
dc.description© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.pt_PT
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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Rheum Dis. 2021 Jun 3:annrheumdis-2021-220097pt_PT
dc.identifier.doi10.1136/annrheumdis-2021-220097pt_PT
dc.identifier.eissn1468-2060
dc.identifier.issn0003-4967
dc.identifier.urihttp://hdl.handle.net/10451/48625
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMJ Publishing Group, Ltd.pt_PT
dc.relation.publisherversionhttps://ard.bmj.com/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectArthritispt_PT
dc.subjectMethotrexatept_PT
dc.subjectPsoriaticpt_PT
dc.subjectTumour necrosis factor inhibitorspt_PT
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 collaborationpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleAnnals of the Rheumatic Diseasespt_PT
person.familyNameSantos
person.givenNameMaria Jose
person.identifier.ciencia-id441A-CD98-8FD6
person.identifier.orcid0000-0002-7946-1365
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication288e25e9-3f56-4cab-afff-0cda5478f1ba
relation.isAuthorOfPublication.latestForDiscovery288e25e9-3f56-4cab-afff-0cda5478f1ba

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