RT Journal Article
SR Electronic
T1 Treatment with Tumor Necrosis Factor Inhibitors in Axial Spondyloarthritis: Comparison Between Private Rheumatology Practices and Academic Centers in a Large Observational Cohort
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 101
OP 105
DO 10.3899/jrheum.140229
VO 42
IS 1
A1 Adrian Ciurea
A1 Ulrich Weber
A1 Daniel Stekhoven
A1 Almut Scherer
A1 Giorgio Tamborrini
A1 Jürg Bernhard
A1 Martin Toniolo
A1 Peter M. Villiger
A1 Pascal Zufferey
A1 Rudolf O. Kissling
A1 Beat A. Michel
A1 Pascale Exer
YR 2015
UL http://www.jrheum.org/content/42/1/101.abstract
AB Objective. To evaluate the initiation of and response to tumor necrosis factor (TNF) inhibitors for axial spondyloarthritis (axSpA) in private rheumatology practices versus academic centers. Methods. We compared newly initiated TNF inhibition for axSpA in 363 patients enrolled in private practices with 100 patients recruited in 6 university hospitals within the Swiss Clinical Quality Management (SCQM) cohort. Results. All patients had been treated with ≥ 1 nonsteroidal antiinflammatory drug and > 70% of patients had a baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4 before anti-TNF agent initiation. The proportion of patients with nonradiographic axSpA (nr-axSpA) treated with TNF inhibitors was higher in hospitals versus private practices (30.4% vs 18.7%, p = 0.02). The burden of disease as assessed by patient-reported outcomes at baseline was slightly higher in the hospital setting. Mean levels (± SD) of the Ankylosing Spondylitis Disease Activity Score were, however, virtually identical in private practices and academic centers (3.4 ± 1.0 vs 3.4 ± 0.9, p = 0.68). An Assessment of SpondyloArthritis international Society (ASAS40) response at 1 year was reached for ankylosing spondylitis in 51.7% in private practices and 52.9% in university hospitals (p = 1.0) and for nr-axSpA in 27.5% versus 25.0%, respectively (p = 1.0). Conclusion. With the exception of a lower proportion of patients with nr-axSpA newly treated with anti-TNF agents in private practices in comparison to academic centers, adherence to ASAS treatment recommendations for TNF inhibition was equally high, and similar response rates to TNF blockers were achieved in both clinical settings.