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Second and third TNF inhibitors in European patients with axial spondyloarthritis : Effectiveness and impact of the reason for switching

Second and third TNF inhibitors in European patients with axial spondyloarthritis : Effectiveness and impact of the reason for switching


Title: Second and third TNF inhibitors in European patients with axial spondyloarthritis : Effectiveness and impact of the reason for switching
Author: Linde, Louise
Ørnbjerg, Lykke Midtbøll
Brahe, Cecilie Heegaard
Wallman, Johan Karlsson
Di Giuseppe, Daniela
Závada, Jakub
Castrejon, Isabel
Díaz-Gonzalez, Federico
Rotar, Ziga
Tomšič, Matija
... 16 more authors Show all authors
Date: 2024-07
Language: English
Scope: 11
Department: Faculty of Medicine
Other departments
Series: Rheumatology (Oxford, England); 63(7)
ISSN: 1462-0324
DOI: 10.1093/rheumatology/kead494
Subject: Gigtarlæknisfræði; adverse events; axial spondyloarthritis; effectiveness; lack of efficacy; switching TNF-inhibitors; Rheumatology; Pharmacology (medical)
URI: https://hdl.handle.net/20.500.11815/4512

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Citation:

Linde , L , Ørnbjerg , L M , Brahe , C H , Wallman , J K , Di Giuseppe , D , Závada , J , Castrejon , I , Díaz-Gonzalez , F , Rotar , Z , Tomšič , M , Glintborg , B , Guðbjörnsson , B , Geirsson , Á J , Michelsen , B , Kristianslund , E K , Santos , M J , Barcelos , A , Nordström , D , Eklund , K K , Ciurea , A , Nissen , M , Akar , S , Hyldstrup , L H , Krogh , N S , Hetland , M L & Østergaard , M 2024 , ' Second and third TNF inhibitors in European patients with axial spondyloarthritis : Effectiveness and impact of the reason for switching ' , Rheumatology (Oxford, England) , vol. 63 , no. 7 , pp. 1882-1892 . https://doi.org/10.1093/rheumatology/kead494 , https://doi.org/10.1093/rheumatology/kead494

Abstract:

OBJECTIVE: To investigate real-world effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA) and the association with 1) treatment line (second and third TNFi-series) and 2) reason for withdrawal from the preceding TNFi (lack of efficacy (LOE) versus adverse events (AE)). METHODS: Prospectively collected routine care data from 12 European registries were pooled. Rates for 12-month drug retention and 6-month remission (Ankylosing Spondylitis Disease Activity Score C-reactive protein inactive disease (ASDAS-ID)) were assessed in second and third TNFi-series and stratified by withdrawal reason. RESULTS: We included 8254 s and 2939 third TNFi-series; 12-month drug retention rates were similar (71%). Six-month ASDAS-ID rates were higher for the second (23%) than third TNFi (16%). Twelve-month drug retention rates for patients withdrawing from the preceding TNFi due to AE versus LOE were similar for the second (68% and 67%) and third TNFi (both 68%), while for the second TNFi, rates were lower in primary than secondary non-responders (LOE < 26 versus ≥26 weeks) (58% versus 71%, p< 0.001). Six-month ASDAS-ID rates for the second TNFi were higher if the withdrawal reason was AE (27%) versus LOE (17%), p< 0.001, while similar for the third TNFi (19% versus 13%, p= 0.20). CONCLUSION: A similar proportion of axSpA patients remained on a second and third TNFi after one year, but with low remission rates for the third TNFi. Remission rates on the second TNFi (but not the third) were higher if the withdrawal reason from the preceding TNFi was AE versus LOE.

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Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology.

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