Anti-TNF Drug Survival In Psoriatic Arthritis Patients Treated In Ordinary Clinical Practice

Glenn Haugeberg¹, Andreas P. Diamantopoulos¹, Agnete Gulati², Mari Hoff³ and Arthur Kavanaugh⁴, ¹Rheumatology, Hospital of Southern Norway Trust, Kristiansand, Norway, ²Rheumatology, St.Olavs Hospital, Trondheim, Norway, ³Rheumatology, St Olavs Hospital, Trondheim, Norway, ⁴University of California San Diego, San Diego, CA

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Biologic agents, drug therapy, psoriatic arthritis and tumor necrosis factor (TNF)

Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment: II

Session Type: Abstract Submissions (ACR)

Background/Purpose: The use of TNF-inhibitors in psoriatic arthritis (PsA) has been shown to improve clinical and radiographic outcome in randomized controlled trials (RCT) and shown to be well tolerated with a rather low rate of drop outs. However, patients in RCT may not be representative of patients followed in ordinary clinical practice. The aim was to assess drug survival of TNF-inhibitor treatment in patients with PsA treated in an ordinary rheumatology clinic in Norway.

Methods: The PsA patients were recruited from an ordinary rheumatology clinic in Norway. All PsA patients in this clinic are monitored and outcome measures and drug data is registered in a clinical hospital computer database. In the database termination and/or change of therapy had been registered. A survival analysis (Kaplan-Meyer) was performed and survival time for sequential therapeutic regimens were compared by Wilcoxon test. Anonymised data was analyzed using SPSS.

Results: We identified 148 patients with PsA who started treatment with their first TNF-inhibitor (from 2002 through 31.12.2012). During the first year of therapy 52 (35%) of these patients stopped treatment. 54 patients started their second and 22 patients started their third or more TNF-inhibitor, and within the first year 33 (61%) and 12 (55%), respectively, stopped treatment. The rate of patients who stopped treatment was highest in the beginning and lover during follow up. This was also seen for the second and ≥ 3^rdTNF inhibitor. Overall drug survival was significantly higher for the first TNF-inhibitor compared to the second drug (p<0.001). The median survival time for the first, second and subsequent drug was 24, 7, and 9 months.

Conclusion: In an ordinary clinic setting, patients with PsA have a significantly reduced drug survival for the subsequent TNF-inhibitor if they fail on the first drug. For each drug, the first year of treatment had the highest termination rate.

Disclosure:

G. Haugeberg,
None;

A. P. Diamantopoulos,
None;

A. Gulati,
None;

M. Hoff,
None;

A. Kavanaugh,
None.

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/anti-tnf-drug-survival-in-psoriatic-arthritis-patients-treated-in-ordinary-clinical-practice/