Research ArticleAccepted Article
Tumour Necrosis Factor Inhibitor monotherapy versus combination therapy for the treatment of psoriatic arthritis: combined analysis of European biologics databases
Matthew L. Thomas, Gavin Shaddick, Rachel Charlton, Charlotte Cavill, Richard Holland, Florenzo Iannone, Giovanni Lapadula, Simona Lopriore, Jakub Závada, Michal Uher, Karel Pavelka, Lenka Szczukova, Prodromos Sidiropolous, Irini Flouri, Alexandros Drosos, Burkhard Möller, Michael J Nissen, Rüdiger B Müller, Almut Scherer, Neil McHugh and Alison Nightingale
The Journal of Rheumatology April 2020, jrheum.190815; DOI: https://doi.org/10.3899/jrheum.190815
Matthew L. Thomas
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Gavin Shaddick
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Rachel Charlton
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Charlotte Cavill
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Richard Holland
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Florenzo Iannone
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Giovanni Lapadula
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Simona Lopriore
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Jakub Závada
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Michal Uher
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Karel Pavelka
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Lenka Szczukova
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Prodromos Sidiropolous
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Irini Flouri
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Alexandros Drosos
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Burkhard Möller
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Michael J Nissen
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Rüdiger B Müller
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Almut Scherer
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Neil McHugh
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Alison Nightingale
Department of Mathematical Science, University of Bath, UK; Department of Mathematics, University of Exeter, UK; Department of Pharmacy & Pharmacology, University of Bath, UK; Royal National Hospital for Rheumatic Diseases, Bath, UK; Rheumatology Unit – DETO, University of Bari, Italy; Institute of Rheumatology, Prague, Czech Republic; Institute of Biostatistics and Analytics, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Rheumatology, Clinical Immunology, Medical School, University of Crete, Greece; Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina; Department of Rheumatology, Immunology & Allergology, Inselspital, University Hospital Bern,; Switzerland Department of Rheumatology, University Hospital Geneva, Switzerland; Cantonal Hospital, St Gallen, Switzerland; SCQM Foundation, Zürich, Switzerland. The study was funded by a non-restricted investigator initiated award from Pfizer. Address correspondence to Professor Neil McHugh, Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK. Email: n.j.mchugh@bath.ac.uk
Abstract
Objective To investigate whether tumour necrosis factor inhibitor (TNFi) combination therapy with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) is more effective for psoriatic arthritis (PsA) and/or improves TNFi drug survival compared to TNFi monotherapy.
Methods Five PsA biologics cohorts were investigated between 2000 and 2015; the ATTRA registry (Czech Republic), the Swiss Clinical Quality Management PsA registry, the Hellenic Registry of Biologics Therapies (Greece), the University of Bari PsA biologics database (Italy) and the Bath PsA cohort (UK). Drug persistence was analysed using Kaplan-Meier and equality of survival using Log-Rank tests. Comparative effectiveness was investigated using logistic regression with propensity scores. Separate analyses were performed on: (a) the combined Italian/Swiss cohorts for change in rate of DAS-28; and (b) the combined Italian, Swiss and Bath cohorts for change in rate of HAQ.
Results In total, 2294 patients were eligible for the drug survival analysis. In the Swiss (p=0.002), Greek (p=0.021) and Bath (p=0.014) databases patients starting TNFi in combination with MTX had longer drug survival compared to monotherapy, whilst in Italy the monotherapy group persisted longer (p=0.030). In patients from the combined Italian/Swiss dataset (n=1066) there was no significant difference between treatment arms in rate of change of DAS28. Similarly, when also including the Bath cohort (n=1205) there was no significant difference in rate of change of HAQ.
Conclusion Combination therapy of a TNFi with a csDMARD does not appear to affect improvement of disease activity or HAQ versus TNFi monotherapy but may improve TNFi drug survival.
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In this issue
The Journal of Rheumatology
Vol. 47, Issue 8
1 Aug 2020
Accepted manuscript
Tumour Necrosis Factor Inhibitor monotherapy versus combination therapy for the treatment of psoriatic arthritis: combined analysis of European biologics databases
Matthew L. Thomas, Gavin Shaddick, Rachel Charlton, Charlotte Cavill, Richard Holland, Florenzo Iannone, Giovanni Lapadula, Simona Lopriore, Jakub Závada, Michal Uher, Karel Pavelka, Lenka Szczukova, Prodromos Sidiropolous, Irini Flouri, Alexandros Drosos, Burkhard Möller, Michael J Nissen, Rüdiger B Müller, Almut Scherer, Neil McHugh, Alison Nightingale
The Journal of Rheumatology Apr 2020, jrheum.190815; DOI: 10.3899/jrheum.190815
Accepted manuscript
Tumour Necrosis Factor Inhibitor monotherapy versus combination therapy for the treatment of psoriatic arthritis: combined analysis of European biologics databases
Matthew L. Thomas, Gavin Shaddick, Rachel Charlton, Charlotte Cavill, Richard Holland, Florenzo Iannone, Giovanni Lapadula, Simona Lopriore, Jakub Závada, Michal Uher, Karel Pavelka, Lenka Szczukova, Prodromos Sidiropolous, Irini Flouri, Alexandros Drosos, Burkhard Möller, Michael J Nissen, Rüdiger B Müller, Almut Scherer, Neil McHugh, Alison Nightingale
The Journal of Rheumatology Apr 2020, jrheum.190815; DOI: 10.3899/jrheum.190815
