Presence of peripheral arthritis and male sex predicting continuation of anti–tumor necrosis factor therapy in ankylosing spondylitis: An observational prospective cohort study from the South Swedish arthritis treatment group register
Kristensen, Lars Erik LU ; Karlsson, Johan LU ; Englund, Martin LU
; Petersson, Ingemar
LU
; Saxne, Tore
LU
and Geborek, Pierre
LU
(2010)
In Arthritis Care and Research
62(10).
p.1362-1369
- Abstract
- Objective:
To examine clinical characteristics as possible predictors of long-term treatment continuation with adalimumab, etanercept, and infliximab in ankylosing spondylitis (AS) patients who had never taken biologics treated in clinical practice.
Methods:
Patients in southern Sweden with active AS starting biologic therapy for the first time between October 1999 and December 2008 (n = 243, 75% men) were included in a structured clinical followup over 2 years. Patients with clinical spondylitis had not responded to at least 2 nonsteroidal antiinflammatory drugs, whereas patients who also had peripheral arthritis (n = 121) had additionally failed at least 1 conventional disease-modifying antirheumatic... (More) - Objective:
To examine clinical characteristics as possible predictors of long-term treatment continuation with adalimumab, etanercept, and infliximab in ankylosing spondylitis (AS) patients who had never taken biologics treated in clinical practice.
Methods:
Patients in southern Sweden with active AS starting biologic therapy for the first time between October 1999 and December 2008 (n = 243, 75% men) were included in a structured clinical followup over 2 years. Patients with clinical spondylitis had not responded to at least 2 nonsteroidal antiinflammatory drugs, whereas patients who also had peripheral arthritis (n = 121) had additionally failed at least 1 conventional disease-modifying antirheumatic drug (DMARD) treatment course. The mean ± SD age at inclusion was 43 ± 12 years, with a mean ± SD disease duration prior to treatment of 16 ± 12 years.
Results:
The 2-year drug continuation rate was 74%. Male sex (hazard ratio [HR] of premature discontinuation 0.36 [95% confidence interval (95% CI) 0.19–0.68]) and the presence of peripheral arthritis (HR 0.49 [95% CI 0.27–0.88]) were found to be significant predictors of better drug survival. Furthermore, a trend was seen for more favorable drug continuation on treatment with etanercept as compared with infliximab (HR 0.50 [95% CI 0.25–1.04], P = 0.062), whereas no differences were found comparing the 3 anti–tumor necrosis factor agents in other ways. Higher baseline C-reactive protein level (HR 0.99 [95% CI 0.97–1.00], P = 0.12) and concomitant treatment with nonbiologic DMARDs (HR 0.61 [95% CI 0.34–1.10], P = 0.10) also showed trends to entail better drug adherence.
Conclusion:
AS patients in this study have an excellent 2-year drug survival rate of 74%. Significant predictors for treatment continuation in this study were male sex and the presence of peripheral arthritis. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1609837
- author
- Kristensen, Lars Erik
LU
; Karlsson, Johan
LU
; Englund, Martin
LU
; Petersson, Ingemar
LU
; Saxne, Tore
LU
and Geborek, Pierre
LU
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Arthritis Care and Research
- volume
- 62
- issue
- 10
- pages
- 1362 - 1369
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- wos:000283185300002
- pmid:20506310
- scopus:77957666794
- pmid:20506310
- ISSN
- 2151-4658
- DOI
- 10.1002/acr.20258
- language
- English
- LU publication?
- yes
- id
- 584896e4-0655-4f2d-a3fd-a253c8f3e86d (old id 1609837)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/20506310?dopt=Abstract
- date added to LUP
- 2016-04-01 10:12:22
- date last changed
- 2022-04-19 23:46:39
@article{584896e4-0655-4f2d-a3fd-a253c8f3e86d,
abstract = {{Objective:<br/><br>
To examine clinical characteristics as possible predictors of long-term treatment continuation with adalimumab, etanercept, and infliximab in ankylosing spondylitis (AS) patients who had never taken biologics treated in clinical practice.<br/><br>
<br/><br>
Methods:<br/><br>
Patients in southern Sweden with active AS starting biologic therapy for the first time between October 1999 and December 2008 (n = 243, 75% men) were included in a structured clinical followup over 2 years. Patients with clinical spondylitis had not responded to at least 2 nonsteroidal antiinflammatory drugs, whereas patients who also had peripheral arthritis (n = 121) had additionally failed at least 1 conventional disease-modifying antirheumatic drug (DMARD) treatment course. The mean ± SD age at inclusion was 43 ± 12 years, with a mean ± SD disease duration prior to treatment of 16 ± 12 years.<br/><br>
<br/><br>
Results:<br/><br>
The 2-year drug continuation rate was 74%. Male sex (hazard ratio [HR] of premature discontinuation 0.36 [95% confidence interval (95% CI) 0.19–0.68]) and the presence of peripheral arthritis (HR 0.49 [95% CI 0.27–0.88]) were found to be significant predictors of better drug survival. Furthermore, a trend was seen for more favorable drug continuation on treatment with etanercept as compared with infliximab (HR 0.50 [95% CI 0.25–1.04], P = 0.062), whereas no differences were found comparing the 3 anti–tumor necrosis factor agents in other ways. Higher baseline C-reactive protein level (HR 0.99 [95% CI 0.97–1.00], P = 0.12) and concomitant treatment with nonbiologic DMARDs (HR 0.61 [95% CI 0.34–1.10], P = 0.10) also showed trends to entail better drug adherence.<br/><br>
<br/><br>
Conclusion:<br/><br>
AS patients in this study have an excellent 2-year drug survival rate of 74%. Significant predictors for treatment continuation in this study were male sex and the presence of peripheral arthritis.}},
author = {{Kristensen, Lars Erik and Karlsson, Johan and Englund, Martin and Petersson, Ingemar and Saxne, Tore and Geborek, Pierre}},
issn = {{2151-4658}},
language = {{eng}},
number = {{10}},
pages = {{1362--1369}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Arthritis Care and Research}},
title = {{Presence of peripheral arthritis and male sex predicting continuation of anti–tumor necrosis factor therapy in ankylosing spondylitis: An observational prospective cohort study from the South Swedish arthritis treatment group register}},
url = {{http://dx.doi.org/10.1002/acr.20258}},
doi = {{10.1002/acr.20258}},
volume = {{62}},
year = {{2010}},
}