Persistence of tumor necrosis factor inhibitor or conventional synthetic disease-modifying antirheumatic drug monotherapy or combination therapy in psoriatic arthritis in a real-world setting

This study described treatment patterns in a psoriatic arthritis (PsA) patient registry for new or ongoing tumor necrosis factor inhibitor (TNFi) monotherapy, conventional synthetic disease-modifying antirheumatic drug (csDMARD) monotherapy, or TNFi/csDMARD combination therapy. This retrospective an...

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Bibliographic Details
Published in:	Rheumatology international Vol. 39; no. 9; pp. 1547 - 1558
Main Authors:	Mease, Philip J., Accortt, Neil A., Rebello, Sabrina, Etzel, Carol J., Harrison, Ryan W., Aras, Girish A., Gharaibeh, Mahdi M. F., Greenberg, Jeffrey D., Collier, David H.
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2019 Springer Nature B.V
Subjects:	Adult Aged Antirheumatic Agents - adverse effects Antirheumatic Agents - therapeutic use Arthritis Arthritis, Psoriatic - diagnosis Arthritis, Psoriatic - drug therapy Arthritis, Psoriatic - immunology Clinical Trials Drug Substitution - trends Drug Therapy, Combination Drug Utilization - trends Female Humans Male Medicine Medicine & Public Health Middle Aged NCT NCT02530268 Necrosis Patients Practice Patterns, Physicians' - trends Psoriatic arthritis Registries Retrospective Studies Rheumatology Time Factors Treatment Outcome Tumor Necrosis Factor Inhibitors - adverse effects Tumor Necrosis Factor Inhibitors - therapeutic use Tumor necrosis factor-TNF United States United States Tumor necrosis factor-alpha Biological therapy Antirheumatic agents Methotrexate Psoriatic arthritis
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Summary:	This study described treatment patterns in a psoriatic arthritis (PsA) patient registry for new or ongoing tumor necrosis factor inhibitor (TNFi) monotherapy, conventional synthetic disease-modifying antirheumatic drug (csDMARD) monotherapy, or TNFi/csDMARD combination therapy. This retrospective analysis included adults with PsA who enrolled in the Corrona PsA/spondyloarthritis registry between March 21, 2013 (registry initiation), and January 31, 2017, and received an approved TNFi and/or csDMARD as “existing use” starting before registry entry or “initiated use” starting on/after registry entry. Therapy persistence was defined as index therapy use for ≥ 12 months without a treatment gap of ≥ 30 days. Among the evaluable patients with existing TNFi monotherapy ( n = 251), csDMARD monotherapy ( n = 225), and combination therapy ( n = 214), 93, 87, and 87% were persistent for ≥ 12 months, and another 6, 5, and 5%, respectively, had no change with < 12 months of follow-up after first use. Among evaluable patients who initiated use of TNFi monotherapy ( n = 26), csDMARD monotherapy ( n = 35), and combination therapy ( n = 15), 50, 43, and 53% were persistent for ≥ 12 months, and another 27, 20, and 20%, respectively, had no change with < 12 months of follow-up after first use. After initiation of index therapy, most changes (19–27% of patients) were discontinuation; 4–13% switched biologic therapy during follow-up. The results of this analysis of real-world treatment patterns in a PsA patient registry suggest that nonpersistence for TNFi monotherapy, csDMARD monotherapy, or TNFi/csDMARD combination therapy occurs more commonly after initiation of therapy than in patients with existing therapy. Trial registration: NCT02530268.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0172-8172 1437-160X
DOI:	10.1007/s00296-019-04345-1