High Baseline Patient’s Compared with Evaluator’s Global Assessment Is Associated with Lower Retention and Remission Rates of First TNF Inhibitor in Psoriatic Arthritis Patients - Data from the EuroSpA Research Collaboration Network

Brigitte Michelsen¹, Lykke Midtbøll Ørnbjerg ², Herman Mann ³, Tore Kvien ⁴, Michael J. Nissen ⁵, Maria José Santos ⁶, Dan Nordström ⁷, Lennart Jacobsson ⁸, Ziga Rotar ⁹, Bjorn Gudbjornsson ¹⁰, Süleyman Serdar Koca ¹¹, Catalin Codreanu ¹², Manuel Pombo-Suarez ¹³, Irene van der Horst-Bruinsma ¹⁴, Anne Gitte Loft ¹⁵, Karel Pavelka ³, Eirik Kristianslund ¹⁶, Burkhard Moeller ¹⁷, Elsa Vieira-Sousa ¹⁸, Anna Mari Hokkanen ¹⁹, Ulf Lindström ²⁰, Matija Tomsic ²¹, Thorvardur J Love ²², Abdurrahman Tufan ²³, Ruxandra IONESCU ²⁴, Carlos Sánchez-Piedra ²⁵, Marleen van de Sande ²⁶, Gary Macfarlane ²⁷, Florenzo Iannone ²⁸, Lise Hyldstrup ², Mikkel Østergaard ²⁹ and Merete Lund Hetland ³⁰, ¹Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Denmark/ Hospital of Southern Norway Trust, Kristiansand, Norway/ Diakonhjemmet Hospital, Oslo, Norway, Oslo, Norway, ²Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Denmark, Copenhagen, Denmark, ³Institute of Rheumatology, Department of Rheumatology, 1st Faculty of Medicine, Prague, Czech Republic, Prague 2, Czech Republic, ⁴Diakonhjemmet Hospital, Dept. of Rheumatology / University of Oslo, Faculty of Medicine, Oslo, Norway, ⁵University Hospital Geneva, Geneva, Switzerland, ⁶Rheumatology department, Hospital Garcia de Orta, Almada, Portugal, ⁷Department of Medicine, ROB-FIN, Helsinki University Hospital and Helsinki University, Helsinki, Finland., Helsinki, Finland, ⁸Dept of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden,, Gothenburg, Sweden, ⁹UMC LJUBLJANA, DPT. OF RHEUMATOLOGY, LJUBLJANA, Slovenia, ¹⁰Centre for Rheumatology Research, Landspitali and Faculty of Medicine, University of Iceland, Reykjavik, Iceland, ¹¹Fırat University School of Medicine Division of Rheumatology, Elazığ, Turkey, ¹²Center of Rheumatic Diseases, University of Medicine and Pharmacy, Bucharest, Romania., Bucharest, Romania, ¹³Unit Research, Spanish Society of Rheumatology, Madrid, Spain, ¹⁴Amsterdam University Medical Center, Amsterdam, Netherlands, ¹⁵Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark, Århus, Denmark, ¹⁶Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway., Oslo, Norway, ¹⁷University Hospital Bern, Bern, Switzerland, ¹⁸Rheumatology and Metabolic Bone Diseases, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, EPE | Rheumatology Research Unit, Instituto de Medicina Molecular - Faculty of Medicine, University of Lisbon, Lisbon Academic Medical Centre, Lisbon, Portugal,, Lisbon, Portugal, ¹⁹Helsinki University Hospital, Helsinki, Finland, ²⁰University of Gothenburg, Gothenburg, Sweden, ²¹Department of Rheumatology, University Medical Center Ljubljana, Slovenia, Ljubljana, Slovenia, ²²Faculty of Medicine, University of Iceland, Reykjavik, Iceland, ²³Division of Rheumatology, Gazi University School of Medicine, Ankara, Turkey, Ankara, Turkey, ²⁴SPITALUL CLINIC SFANTA MARIA, Bucharest, ²⁵Research Unit, Spanish Society of Rheumatology, Madrid, Spain, ²⁶Amsterdam UMC, Amsterdam, Netherlands, ²⁷University of Aberdeen, Aberdeen, United Kingdom, ²⁸Department of Emergency and Transplantation , Rheumatology Unit, University Hospital of Bari, Bari, Italy., Bari, Italy, ²⁹Copenhagen Center for Arthritis Research, University of Copenhagen, Copenhagen, Denmark, ³⁰DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen, Denmark

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Biologic drugs, patient-reported outcome measures, Psoriatic arthritis, remission and registries

Session Information

Date: Sunday, November 10, 2019

Title: 3S076: Patient Outcomes, Preferences, & Attitudes I: Patient Reported Outcomes (833–838)

Session Type: ACR Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: Discordance between baseline patient’s and evaluator’s global assessment of disease activity is common¹ and may reduce the likelihood of remission following tumor necrosis factor inhibitor (TNFi) treatment in patients with psoriatic arthritis (PsA).² However, the impact of such discordance on retention rates of TNFi in PsA patients remains unexplored. Hence, the aim of this study was to explore the impact of discordance, defined as patient’s minus evaluator’s global assessment (ΔPEG), on retention rates and remission rates (DAS28(3)CRP (without patient’s global) and DAS28(4)CRP (including patient’s global)) in PsA patients initiating their first TNFi treatment. We used pooled data from the European Spondyloarthritis Research Collaboration Network (EuroSpA).

Methods: TNFi naïve PsA patients from 11 European registries in EuroSpA were included. Kaplan-Meier analyses were used to estimate TNFi retention rates after 6/12/24 months, with comparison between baseline ΔPEG quartiles using the log rank test, stratified by gender. Remission rates were compared between different ΔPEG quartiles with Chi-square test, stratified by gender.

Results: A total of 5855 PsA patients were included. Mean (SD) age for women (n=2988) / men (n=2867) were 49.3 (12.5) / 47.4 (11.7) years, disease duration 6.6 (7.3) / 6.7 (7.2) years, median (25-75 percentiles) baseline ΔPEG 17 (0-38) / 10 (0-30) mm. Retention rates and DAS28(4)CRP but not DAS28(3)CRP remission rates were lower for higher quartiles of baseline ΔPEG (table, figure).

Conclusion: High baseline discordance (ΔPEG) was associated with lower TNFi retention rates and with lower DAS28(4)CRP remission rates, but not DAS28(3)CRP remission rates, after 6, 12 and 24 months’ follow-up in both male and female PsA patients. The choice of remission criteria in the follow-up of PsA patients may affect important treatment decisions, and may be of particular impact in patients with high baseline ΔPEG.

Table. Retention and remission rates of first TNFi in PsA patients.

Figure. Retention rates of first TNFi across ΔPEG quartiles, censored by 104 weeks.

Disclosure: B. Michelsen, Novartis, 2, 5; L. Midtbøll Ørnbjerg, Novartis, 2; H. Mann, None; T. Kvien, AbbVie, 2, 8, Biogen, 5, 8, Biogen, Egis, Eli Lilly, Hikma, Mylan, Novartis/Sandoz, Oktal, Hospira/Pfizer, Sanofi and UCB, 5, BMS, 8, Celltrion, 8, Egis, 5, 8, Eli Lilly, 5, 8, Hikma, 5, 8, Hospira/Pfizer, 2, 5, 8, MSD, 2, 8, Mylan, 5, 8, Novartis, 8, Novartis/Sandoz, 5, 8, Oktal, 5, 8, Orion Pharma, 8, Roche, 2, 8, Sandoz, 8, Sanofi, 5, 8, UCB, 5, 8; M. Nissen, Abbvie, Celgene, Lilly, MSD, Novartis, Pfizer, 5, 8; M. Santos, AbbVie, 8, Biogen, 8, Novartis, 8, Pfizer, 8, Roche, 8; 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; L. Jacobsson, 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; S. Koca, None; 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; 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; A. Loft, None; 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; E. Kristianslund, None; B. Moeller, AbbVie, 2, 8, Eli Lilly, 2, 8, Janssen, 2, 8, Merck, 2, 8, Novartis, 2, 8, Pfizer, 2, 8, UCB, 2, 9; E. Vieira-Sousa, None; A. Hokkanen, None; U. Lindström, None; M. Tomsic, None; T. Love, None; A. Tufan, None; 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. van de Sande, None; 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; L. Hyldstrup, Novartis, 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; 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.

To cite this abstract in AMA style:

Michelsen B, Midtbøll Ørnbjerg L, Mann H, Kvien T, Nissen M, Santos M, Nordström D, Jacobsson L, Rotar Z, Gudbjornsson B, Koca S, Codreanu C, Pombo-Suarez M, van der Horst-Bruinsma I, Loft A, Pavelka K, Kristianslund E, Moeller B, Vieira-Sousa E, Hokkanen A, Lindström U, Tomsic M, Love T, Tufan A, IONESCU R, Sánchez-Piedra C, van de Sande M, Macfarlane G, Iannone F, Hyldstrup L, Østergaard M, Lund Hetland M. High Baseline Patient’s Compared with Evaluator’s Global Assessment Is Associated with Lower Retention and Remission Rates of First TNF Inhibitor in Psoriatic Arthritis Patients – Data from the EuroSpA Research Collaboration Network [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/high-baseline-patients-compared-with-evaluators-global-assessment-is-associated-with-lower-retention-and-remission-rates-of-first-tnf-inhibitor-in-psoriatic-arthritis-patients-data/. Accessed .

« Back to 2019 ACR/ARP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/high-baseline-patients-compared-with-evaluators-global-assessment-is-associated-with-lower-retention-and-remission-rates-of-first-tnf-inhibitor-in-psoriatic-arthritis-patients-data/