ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2462

Comparison Of Tumor Necrosis Factor Inhibitor Use For Ankylosing Spondylitis At University Rheumatology Clinics In Scotland and Oregon

Anusha Reddy1, Abhijeet Danve2, Kiana Vakil-Gilani3, Jennifer H. Ku4, Sanjay Ganhasan5, Alison Black6 and Atul A. Deodhar3, 1Rheumatology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom, 2Rheumatology, Oregon Health and Science University, Portland, OR, 3Arthritis and Rheumatic diseases, Oregon Health and Science University, Portland, OR, 4Arthritis and Rheumatic Diseases, Oregon Health and Science University, Portland, OR, 5Forresterhill Rd Aberdeen AB25 2ZN, United Kingdom, Aberdeen Royal Infirmary, Aberdeen, United Kingdom, 6Aberdeen Royal Infirmary, Aberdeen, United Kingdom

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Ankylosing spondylitis (AS) and anti-TNF therapy

  • Tweet
  • Email
  • Print
Session Information

Session Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment III

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Use of tumor necrosis factor inhibitors (TNFi) for ankylosing spondylitis (AS) is directed by national guidelines in the UK. However in the US, in the absence of treatment recommendations, the use of TNFi is dictated by local practice patterns.  We compared the use of TNFi in the treatment of AS at Aberdeen Royal Infirmary (ARI) in Scotland, and Oregon Health & Science University (OHSU) in Oregon. 

Methods:

This was a retrospective analysis of patients who were newly started on TNFi for treatment of AS between 2007 and 2012 at OHSU, and between 2004 and 2011 at ARI. Data on patient demographics, clinical characteristics and treatment were collected from electronic medical records. Descriptive analysis, Mann-Whitney U test and chi-square test (Fisher’s exact test if N <5) was used to compare the two groups of patients.

Results:

There were significant differences between the 2 groups regarding age, HLA B27 positivity, NSAID use, physical function and presence of depression, (see Table). Time to start TNFi after the symptom onset was median 10 (11.5) years at ARI compared to 6 (8) years at OHSU. The baseline BASDAI at the time of initiation of TNFi at ARI was 7 (2.2) compared to 6 (3.9) at OHSU (p=0.04). Adalimumab was the most frequently prescribed TNFi in both places (67% of ARI and 51% of OHSU patients).  Percentage reduction in BASDAI in 1 year from baseline was significantly higher at ARI (64%) as compared to OHSU (17%). According to the NICE guidelines followed in the UK, AS patients are not allowed to switch the TNFi for inefficacy. In OHSU, 22% patients switched TNFi once and 12% switched TNFi more than once, for either allergic reaction or inefficacy. These patients had mean BASDAI score of 3.45 (2.6) and 3.97 (3) respectively after one year.

Conclusion:

Patients at ARI had higher baseline BASDAI and longer time to start TNFi after symptom onset as compared to OHSU.  Higher prevalence of depression in OHSU patients may have affected the change in BASDAI, which is a subjective measure.   OHSU patients who switched TNFi due to inadequate response had a good outcome suggesting that switching TNFi is a valid strategy, which is currently not available to patients in the UK.

          

OHSU (2007-2012) N= 41

N, median (iqr)

Or N (%)

ARI 2004-2011 N=67

N, median (iqr)

Or N (%)

P value

Age years

 

 45 (12)

 

40.5 (17.5)

0.048*

Female

               14 (34.2)

 

14 (21.9)

0.17

Symptom onset to time of starting TNFi in years 

                30, 6 (8)

 

20, 10 (11.5)

 

0.16

Positive HLA-B27

20 (64.5)

 

15 (100)

<0.01*

NSAID use

31 (75.6)

 

64 (100)

<0.01*

 Baseline BASDAI

16,  6.0 (3.9)

 

61, 7.0 (2.2)

0.04*

Baseline RAPID 3

26, 5.2 (2.2)

 

N/A

N/A

Pain

26,  7 (2.5)

59, 7.4 (2.4)

0.97

Function 

26,  2.7 (2.3)

 

60,  6.2 (3.3)

<0.01*

BASMI

N/A

58,  3.7 (3.2)

N/A

Uveitis

4 (9.8)

11 (17.2)

0.40

Psoriasis

5 (12.2)

5 (7.8)

0.51

Inflammatory bowel disease (IBD)

6 (14.6)

4 (6.4)

0.18

Depression

13 (32.5)%

4 (6.3)

<0.01*

Fibromyalgia

5 (12.2)

N/A

N/A

Ischemic heart disease

2 (4.9)%

1 (1.6)

0.32

% change in BASDAI at 1 year

                    17.6%

                   64.7%

<0.01

 

* statistical significanceN/A

“not applicable”

 

 

 


Disclosure:

A. Reddy,
None;

A. Danve,
None;

K. Vakil-Gilani,
None;

J. H. Ku,
None;

S. Ganhasan,
None;

A. Black,
None;

A. A. Deodhar,

UCB Pharma, Abbott, Amgen, Janssen, Novartis,

2,

UCB Pharma, Abbott, Amgen, Janssen, Novartis,

5,

Abbott, Pfizer, UCB Pharma,

9.

  • Tweet
  • Email
  • Print

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparison-of-tumor-necrosis-factor-inhibitor-use-for-ankylosing-spondylitis-at-university-rheumatology-clinics-in-scotland-and-oregon/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences