Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Long-term data on drug survival of TNF inhibitors (TNFi) in the treatment of spondyloarthropathies are still lacking. The aim of the study is to analyze in a setting of real-life the 8-year retention rate of the first TNFi for the treatment of psoriatic arthritis (PsA) and axial spondyloarthritis (ax-SpA) and to compare the between-group discontinuation rates for each TNFi (infliximab [IFX], etanercept [ETN], and adalimumab [ADA]).
Methods: Data were retrospectively extracted from three local registries including all patients affected by PsA and ax-SpA treated with a biologic drug between January 2002 and May 2014. The analysis was limited to patients treated with IFX, ETN, or ADA as first-line biologic agent, with at least 1-year follow-up period. The 8-year drug survival was evaluated by Kaplan-Meier method and the risk for discontinuation among the 3 treatment groups was compared by a stratified log-rank test. The comparison of reasons for drug withdrawal among treatment subgroups was performed by the Fischer’s exact test.
Results: The study population (594 patients) included 322 ax-SpA (69.2% male, median age [±SD] 42 [±12.2] years, median disease duration 5.2 [±8] years), treated with ADA (n=99), ETN (n=40), or IFX (n=183); and 272 PsA (53.7% male, median age 47.9 [±12.2] years, median disease duration 9.1 [±7.3] years), treated with ADA (n=98), ETN (n=75), or IFX (n=99). The overall median survival on treatment of the whole study population was 103.6 months (105.2 and 102.6 months for ax-SpA and PsA, respectively; p=0.3768). The overall retention rate was 62.8% (68.4% versus 59.7% in axSpA and PsA, respectively) at 5 years and 53.3% (56.1% versus 52.4% in axSpA and PsA, respectively) at 8 years. No significant differences emerged in the comparison among ADA, ETN, and IFX in both ax-SpA group (p=0.1113) and PsA group (p=0.4783). The main reported reasons for treatment discontinuation were drug inefficacy (18.2% in ax-SpA versus 25.6% in PsA; p=0.0357) and adverse events (16.4% in ax-SpA and 19.2% in PsA; p=0.45).
Conclusion: In a real-life setting, the 8-year retention rate of the first TNFi in the treatment of spondyloarthropathies was about 50%, with no significant difference between ax-SpA and PsA. The risk of stopping IFX, ETN, and ADA treatment was similar in both ax-SpA and PsA group.
To cite this abstract in AMA style:Favalli EG, Becciolini A, Biggioggero M, Fusaro E, Parisi S, Ariani A, Santilli D, Marchesoni A, Meroni PL. The 8-Year Retention Rate of the First TNF-Inhibitor in the Treatment of Spondyloarthropathies: Real-Life Data from Three Local Registries [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-8-year-retention-rate-of-the-first-tnf-inhibitor-in-the-treatment-of-spondyloarthropathies-real-life-data-from-three-local-registries/. Accessed September 22, 2019.
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