Session Type: Abstract Submissions (ACR)
Background/Purpose: No long term head-to-head comparative studies of anti-TNF agents in psoriatic arthritis have been published. Controversy exists over the selection of initial biologic therapy after DMARDs failure. We aim to assess if patients with psoriatic arthritis (PSO) treated with adalimumab or etanercept after failure to a first line agent (MTX-IR) have different drug survival rates. A secondary objective is to explore the role of MTX co-prescription.
Methods: PSO patients prescribed a first biologic agent after January 1st 2004 were included in the present analysis. The cohort use in the analysis includes patients prescribed either adalimumab (ADA) or etanercept (ETA) as a first biologic treatment. Baseline demographics for both cohorts included age, disease duration, HAQ-DI, fatigue and pain visual analog scale evaluation (VAS), TJC, SJC, DAS 28 ESR, SDAI and patient-years of treatment. Statistical analysis was performed using SAS version 9.3. RHUMADATA® is a clinical database and registry used daily in clinical practice at the IRM and the CORQ.
Results: A total of 134 patients were analysed and no significant differences in baseline characteristics were noted between treatment groups except for morning stiffness and disease duration. The 5 year retention rate of ADA and ETA were respectively 64% and 47% without a significant statistical difference (Log-Rank p=0.084). When combining biologics, the use of DMARDs did not improve drug survival over biologic monotherapy (52% for combination therapy vs. 67% for monotherapy, Log-Rank p=0.74).
Conclusion: In this analysis, adalimumab and etanercept after DMARDs failure have statistically similar 5-years retention rates. Adalimumab, however, demonstrated numerical superiority over etanercept for the entire follow-up period. More data will be required to confirm this observation. Combination with methotrexate did not demonstrate improved 5-year retention.
J. P. Pelletier,
J. P. Raynauld,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparing-adalimumab-and-etanercept-as-first-line-agents-in-patients-with-psoriatic-arthritis-data-from-the-rhumadata-clinical-database-and-registry/