RT Journal Article
SR Electronic
T1 One-Third of European Patients with Axial Spondyloarthritis Reach Pain Remission With Routine Care Tumor Necrosis Factor Inhibitor Treatment
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.220459
DO 10.3899/jrheum.220459
A1 Lykke Midtbøll  Ørnbjerg
A1 Kathrine Rugbjerg
A1 Stylianos Georgiadis
A1 Simon Horskjær  Rasmussen
A1 Ulf Lindström
A1 Karel Pavelka
A1 Neslihan Yilmaz
A1 Ennio Giulio  Favalli
A1 Michael J.  Nissen
A1 Brigitte Michelsen
A1 Elsa Vieira-Sousa
A1 Gareth T.  Jones
A1 Ruxandra Ionescu
A1 Heikki Relas
A1 Carlos Sanchez-Piedra
A1 Matija Tomšič
A1 Arni Jon  Geirsson
A1 Irene van der Horst-Bruinsma
A1 Johan Askling
A1 Anne Gitte  Loft
A1 Lucie Nekvindova
A1 Haner Direskeneli
A1 Florenzo Iannone
A1 Adrian Ciurea
A1 Karen Minde  Fagerli
A1 Maria José  Santos
A1 Gary J.  Macfarlane
A1 Catalin Codreanu
A1 Kari Eklund
A1 Manuel Pombo-Suarez
A1 Ziga Rotar
A1 Bjorn Gudbjornsson
A1 Tamara Rusman
A1 Mikkel Østergaard
A1 Merete Lund  Hetland
YR 2022
UL http://www.jrheum.org/content/early/2023/01/10/jrheum.220459.abstract
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.