PT  - JOURNAL ARTICLE
AU  - Ørnbjerg, Lykke Midtbøll
AU  - Rugbjerg, Kathrine
AU  - Georgiadis, Stylianos
AU  - Rasmussen, Simon Horskjær
AU  - Lindström, Ulf
AU  - Pavelka, Karel
AU  - Yilmaz, Neslihan
AU  - Favalli, Ennio Giulio
AU  - Nissen, Michael J.
AU  - Michelsen, Brigitte
AU  - Vieira-Sousa, Elsa
AU  - Jones, Gareth T.
AU  - Ionescu, Ruxandra
AU  - Relas, Heikki
AU  - Sanchez-Piedra, Carlos
AU  - Tomšič, Matija
AU  - Geirsson, Arni Jon
AU  - van der Horst-Bruinsma, Irene
AU  - Askling, Johan
AU  - Loft, Anne Gitte
AU  - Nekvindova, Lucie
AU  - Direskeneli, Haner
AU  - Iannone, Florenzo
AU  - Ciurea, Adrian
AU  - Fagerli, Karen Minde
AU  - Santos, Maria José
AU  - Macfarlane, Gary J.
AU  - Codreanu, Catalin
AU  - Eklund, Kari
AU  - Pombo-Suarez, Manuel
AU  - Rotar, Ziga
AU  - Gudbjornsson, Bjorn
AU  - Rusman, Tamara
AU  - Østergaard, Mikkel
AU  - Hetland, Merete Lund
TI  - One-Third of European Patients with Axial Spondyloarthritis Reach Pain Remission With Routine Care Tumor Necrosis Factor Inhibitor Treatment
AID  - 10.3899/jrheum.220459
DP  - 2022 Dec 01
TA  - The Journal of Rheumatology
PG  - jrheum.220459
4099  - http://www.jrheum.org/content/early/2023/01/10/jrheum.220459.short
4100  - http://www.jrheum.org/content/early/2023/01/10/jrheum.220459.full
AB  - Objective To investigate the distribution of patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA) initiating a tumor necrosis factor inhibitor (TNFi), to assess the proportion reaching PRO "remission" across registries and treatment series, and to compare patients registered to fulfill the modified New York (mNY) criteria for ankylosing spondylitis (AS) vs patients with nonradiographic axSpA (nr-axSpA). Methods Fifteen European registries contributed PRO scores for pain, fatigue, patient global assessment (PtGA), Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Health Assessment Questionnaire (HAQ) from 19,498 patients with axSpA. Changes in PROs and PRO remission rates (definitions: ≤ 20 mm for pain, fatigue, PtGA, BASDAI, and BASFI; ≤ 0.5 for HAQ) were calculated at 6, 12, and 24 months of treatment. Results Heterogeneity in baseline characteristics and outcomes between registries were observed. In pooled data, 6 months after the start of a first TNFi, pain score was reduced by approximately 60% (median at baseline/ 6/12/24 months: 65/25/20/20 mm) in patients on treatment. Similar patterns were observed for fatigue (68/32/30/25 mm), PtGA (66/29/21/20 mm), BASDAI (58/26/21/19 mm), BASFI (46/20/16/16 mm), and HAQ (0.8/0.4/0.2/0.2). Patients with AS (n = 3281) had a slightly better response than patients with nr-axSpA (n = 993). The Lund Efficacy Index (LUNDEX)-adjusted remission rates at 6 months for pain/fatigue/PtGA/BASDAI/BASFI/HAQ were 39%/30%/38%/34%/35%/48% for the AS cohort and 30%/21%/26%/24%/33%/47% for the nr-axSpA cohort. Better PRO responses were seen with a first TNFi compared to a second and third TNFi. Conclusion Patients with axSpA starting a TNFi achieved high PRO remission rates, most pronounced in those fulfilling the mNY criteria and for the first TNFi.