ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1551

Does Retention and Remission Rates to 2nd and 3rd TNF Inhibitors in Patients with Axial Spondyloarthritis Depend on the Reason from Withdrawal to the Previous Treatment? – Real World Data from 12 European Countries in the EuroSpA Research Collaboration

Lykke Midtbøll Ørnbjerg 1, Cecilie Heegaard Brahe1, Anne Gitte Loft 2, Johan Askling 3, Adrian Ciurea 4, Herman Mann 5, Servet Akar 6, Eirik Kristianslund 7, Dan Nordström 8, Maria José Santos 9, Catalin Codreanu 10, Manuel Pombo-Suarez 11, Ziga Rotar 12, Bjorn Gudbjornsson 13, Daniela DiGuiseppe 14, Michael J. Nissen 15, Karel Pavelka 5, Soner Senel 16, Joe Sexton 17, Kari K. Eklund 18, Anabela Barcelos 19, Ruxandra IONESCU 20, Carlos Sánchez-Piedra 21, Matija Tomsic 22, Arni Jon Geirsson 23, Irene van der Horst-Bruinsma 24, Gary Macfarlane 25, Florenzo Iannone 26, Brigitte Michelsen 1, Lise Hyldstrup 27, Niels Steen Krogh 28, Merete Lund Hetland 29 and Mikkel Østergaard 30, 1EuroSpA Coordinating Center, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Glostrup, Denmark, 2Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark, Århus, Denmark, 3Karolinska Institutet, Stockholm, Sweden, 4University Hospital Zürich, Zürich, Switzerland, 5Institute of Rheumatology, Department of Rheumatology, 1st Faculty of Medicine, Prague, Czech Republic, Prague 2, Czech Republic, 6Izmir Katip Celebi University, Faculty of Medicine, Division of Rheumatology, İzmir, Turkey, 7Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway., Oslo, Norway, 8Department of Medicine, ROB-FIN, Helsinki University Hospital and Helsinki University, Helsinki, Finland., Helsinki, Finland, 9Rheumatology department, Hospital Garcia de Orta, Almada, Portugal, 10Center of Rheumatic Diseases, University of Medicine and Pharmacy, Bucharest, Romania., Bucharest, Romania, 11Rheumatology Unit, Clinical University Hospital of Santiago de Compostela,, Santiago, Spain, 12UMC LJUBLJANA, DPT. OF RHEUMATOLOGY, LJUBLJANA, Slovenia, 13Centre for Rheumatology Research, Landspitali and Faculty of Medicine, University of Iceland, Reykjavik, Iceland, 14Clinical Epidemiology Division, Dept of Medicine Solna, Karolinska Institutet,, Stockholm, Sweden, 15University Hospital Geneva, Geneva, Switzerland, 16Division of Rheumatology, Erciyes University School of Medicine, Kayseri, Turkey, Kayseri, Turkey, 17Diakonhjemmet Hospital, Dept. of Rheumatology, Oslo, Norway, 18ROB-FIN registry, Department of Medicine, Helsinki University and University Hospital, Helsinki, Finland, 19Centro Hospitalar Baixo Vouga | iBemed, University of Aveiro, Aveiro, Portugal, 20SPITALUL CLINIC SFANTA MARIA, Bucharest, 21Research Unit, Spanish Society of Rheumatology, Madrid, Spain, 22Department of Rheumatology, University Medical Center Ljubljana, Slovenia, Ljubljana, Slovenia, 23Centre for Rheumatology Research, University Hospital and Faculty of Medicine, Reykjavik, Iceland, 24Amsterdam University Medical Center, Amsterdam, Netherlands, 25University of Aberdeen, Aberdeen, United Kingdom, 26Department of Emergency and Transplantation , Rheumatology Unit, University Hospital of Bari, Bari, Italy., Bari, Italy, 27Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Denmark, Copenhagen, Denmark, 28Zitelab / DANBIO, Copenhagen, Denmark, 29DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen, Denmark, 30Copenhagen Center for Arthritis Research, University of Copenhagen, Copenhagen, Denmark

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: , ,

Session Information

Date: Monday, November 11, 2019

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster II: Treatment of Axial Spondyloarthritis & Psoriatic Arthritis

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Tumour necrosis factor inhibitors (TNFi) are efficacious in patients with axial spondyloarthritis (axSpA), but still some patients switch to a different TNFi because of adverse effects (AE) or lack of effect (LOE). The EuroSpA Collaboration has previously demonstrated a 1-year retention rate of 79% and 6 months LUNDEX adjusted BASDAI< 4 of 59%1 in patients initiating the first TNFi treatment. Little is known about the effectiveness of switching to a second and third TNFi in patients with axSpA. 

We aim to investigate retention and response rates at 6, 12 and 24 months in patients with axSpA initiating the 2nd and 3rd TNFi in clinical practice across Europe. Secondly, to investigate whether the outcomes were associated with the reason for withdrawal (AE or LOE) from the previous treatment.

Methods: Prospectively collected data on axSpA patients in routine care from 12 European registries were pooled. Kaplan-Meier estimation was used to investigate TNFi retention rates. LUNDEX adjusted2 response rates were calculated for BASDAI< 4 and ASDAS inactive disease (ASDAS< 1.3). Group comparisons were performed by Chi-square test.

Results: A total of 7953 patients initiating their 2nd TNFi and 2782 patients initiating 3rd TNFi were included. Baseline characteristics are shown in the Table.
The overall retention rates for both 2nd and 3rd TNFi at 12 months were 72 % (Figure). Corresponding retention rates for the individual registries ranged from 52-90% and 54-89%, respectively. In both patients who stopped 1st TNFi due to AE or LOE, 12-month retention rate for the 2nd TNFi treatment was 68 %. In patients who stopped the 2nd TNFi due to AE or LOE, 12-month retention rates for the 3rd TNFi treatment were 68 % and 69%, respectively.
For the 2nd and 3rd TNFi, 6 months LUNDEX adjusted BASDAI< 4 were 44% and 37% (p< 0.001), respectively, and for ASDAS inactive disease 18% and 13% (p=0.003) (Table).

Conclusion: Data from 12 European countries demonstrated decreasing response rates with increasing number of previous TNFi, although with only minor difference between 2nd and 3rd. Patients who had withdrawn from the previous TNFi due to LOE had retention rates and remission rates similar to those who had withdrawn due to AE.

Acknowledgement
Novartis Pharma AG and IQVIA for supporting the EuroSpA collaboration.

 References
1 Brahe et al. ACR 2018
2Arthritis Rheum, 2006, 54(2), p:600-6

 


Table

Disclosure: L. Midtbøll Ørnbjerg, Novartis, 2; C. Brahe, Novartis, 2; A. Loft, None; J. Askling, AbbVie, 2, BMS, 2, Lilly, 2, MSD, 2, Pfizer, 2, Roche, 2, Samsung Bioepis, 2, UCB, 2; A. Ciurea, AbbVie, 5, Celgene, 5, Eli Lilly, 5, Janssen-Cilag, 5, MSD, 5, Novartis, 5, Pfizer, 5, UCB, 5; H. Mann, None; S. Akar, Abbvie, 2, 5, Amgen, 2, 5, MSD, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, 8, Roche, 2, 5, UCB, 2, 5; E. Kristianslund, None; D. Nordström, AbbVie, 5, 8, BMS, 5, 8, Celgene, 5, 8, Lilly, 5, 8, MSD, 2, 4, 8, Novartis, 5, 8, Pfizer, 2, 5, 8, Roche, 2, 5, 8, UCB, 5, 8; M. Santos, AbbVie, 8, Biogen, 8, Novartis, 8, Pfizer, 8, Roche, 8; C. Codreanu, AbbVie, 5, 8, Egis, 5, 8, Eli-Lilly, 5, 8, Ewopharma, 5, 8, Mylan, 5, 8, Novartis/Sandoz, 5, 8, Pfizer, 5, 8, Roche, 5, 8, UCB, 5, 8; M. Pombo-Suarez, None; Z. Rotar, AbbVie, 9, Amgen, 5, 8, Eli-Lilly, 9, MSD, 5, Novartis, 9, Pfizer, 9, Sanofi, 5; B. Gudbjornsson, Actavis, 8, Amgen, 8, Novartis, 8, Pfizer, 8; D. DiGuiseppe, None; M. Nissen, Abbvie, Celgene, Lilly, MSD, Novartis, Pfizer, 5, 8; K. Pavelka, AbbVie, 8, Abbvie, 5, 8, Amgen, 5, 8, BMS, 8, Egis, 5, 8, Lilly, 5, 8, MSD, 8, Novartis, 5, 8, Pfizer, 5, 8, Roche, 5, 8, UCB, 8; S. Senel, None; J. Sexton, None; K. Eklund, None; A. Barcelos, Bene, 8, MSD, 5, 8, Pfizer, 5, 8, Novartis, 5, 8, Eli-Lilly, 5; R. IONESCU, Abbvie, 5, 8, Amgen, 5, 8, Alpha Sigma, 5, 8, BMS, 5, 8, Ewopharma, 5, 8, Lilly, 5, 8, Mylan, 5, 8, Novartis, 5, 8, MSD, 5, 8, Pfizer, 5, 8, UCB, 5, 8, Roche, 5, 8, Sandoz, 5, 8; C. Sánchez-Piedra, None; M. Tomsic, None; A. Geirsson, None; I. van der Horst-Bruinsma, AbbVie, 2, 5, 8, Bristol Myers-Squibb, 2, 5, 8, MSD, 2, 5, 8, Novartis, 2, 5, 8, Pfizer, 2, 5, 8, UCB Pharma, 2, 5, 8; G. Macfarlane, Celgene, 2; F. Iannone, AbbVie, 5, 8, BMS, 5, 8, Janssen, 5, 8, lilly, 5, 8, Lilly, 5, 8, MSD, 2, 5, 8, Novartis, 5, 8, Pfizer, 5, 8, Roche, 5, 8, Sanofi, 5, 8, UCB, 5, 8; B. Michelsen, Novartis, 2; L. Hyldstrup, Novartis, 2; N. Krogh, None; M. Lund Hetland, Abbvie, 2, AbbVie, 2, Biogen, 2, BMS, 2, CellTrion, 2, 9, MSD, 2, Novartis, 2, Orion, 2, Pfizer, 2, Samsung, 2, UCB, 2; M. Østergaard, AbbVie, 2, 8, 9, Abbvie, 2, 5, 8, Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, UCB, 5, 8, Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, and UCB, 5, 8, Abbvie, Celgene, Centocor, Merck, and Novartis, 2, Abbvie, Celgene, Centocor, Merck, Novartis, 2, BMS, 2, 5, 8, 9, Boehringer Ingelheim, 5, 8, Boehringer-Ingelheim, 2, 8, Boehringer-ingelheim, 9, Celgene, 2, 5, 8, Centocor, 2, Eli Lilly, 5, 8, 9, Eli Lilly and Company, 5, 8, Eli-Lilly, 2, 8, Hospira, 2, 5, 8, Janssen, 2, 5, 8, 9, Merck, 2, 5, 8, 9, Novartis, 2, 5, 8, Novo, 2, 5, 8, Novo Nordisk, 5, 8, Orion, 2, 5, 8, Pfizer, 2, 5, 8, 9, Regeneron, 2, 5, 8, Roche, 2, 5, 8, roche, 9, Sandoz, 2, 8, Sanofi, 2, 8, UCB, 2, 5, 8.

To cite this abstract in AMA style:

Midtbøll Ørnbjerg L, Brahe C, Loft A, Askling J, Ciurea A, Mann H, Akar S, Kristianslund E, Nordström D, Santos M, Codreanu C, Pombo-Suarez M, Rotar Z, Gudbjornsson B, DiGuiseppe D, Nissen M, Pavelka K, Senel S, Sexton J, Eklund K, Barcelos A, IONESCU R, Sánchez-Piedra C, Tomsic M, Geirsson A, van der Horst-Bruinsma I, Macfarlane G, Iannone F, Michelsen B, Hyldstrup L, Krogh N, Lund Hetland M, Østergaard M. Does Retention and Remission Rates to 2nd and 3rd TNF Inhibitors in Patients with Axial Spondyloarthritis Depend on the Reason from Withdrawal to the Previous Treatment? – Real World Data from 12 European Countries in the EuroSpA Research Collaboration [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/does-retention-and-remission-rates-to-2nd-and-3rd-tnf-inhibitors-in-patients-with-axial-spondyloarthritis-depend-on-the-reason-from-withdrawal-to-the-previous-treatment-real-world-data-from/. Accessed .

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