Session Information
Date: Monday, November 6, 2017
Title: ARHP Spondylarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment Poster
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: The incorporation of biological disease modifying drugs (b–
DMARD) has substantially improved the outcome of patients with Psoriatic Arthritis
(PsA). Our aim was to evaluate b-DMARD´s patterns, their accumulated survival and long-
term efficacy in patients with PsA using the Lund Efficacy Index (LUNDEX).
Methods: A retrospective multicentric study was carried out through the collection of
medical records data. Patients aged ≥ 18 years with PsA by CASPAR criteria who had
started therapy with b-DMARD were included. Socio-demographic and clinical data were
collected. We consigned beginning date of b-DMARD, concomitant treatment, suspension
or change of b-DMARD, reasons of the suspensions. A therapeutic response was defined
according to minimal disease activity (MDA) at 6 and 12 months and then annually since
the beginning of biological treatment. Statistical analysis: Student T test and Chi2 test for
univariate analysis. Cumulative survival was assessed using Kaplan Meier curves and
comparisons using Log Rank. Multivariate Cox regression analysis was performed.
Results: Seventy-two patients with PsA were included, 39 (54.2%) were men. The median
of age was 54.5 years (IQR 45-61) and median disease duration was 11 years (IQR 6-15).
71.2% (n=42) of patients had comorbidities. Regarding the first biological agent, 45.8%
received Adalimumab (ADA), 36.1% Etanercept (ETN), 5.6% Certolizumab, 4.2%
Infliximab and Ustekinumab, 1.4% Golimumab. 25.4% (n=15) received them as
monotherapy. 79.7% received NSAIDs, 61% Methotrexate, 25.9% Prednisone (≤10
mg/day), 12.1% Leflunomide and 1.7% Sulfasalazine as concomitant treatment. 35.8%
(n=19) of patients stopped taking the first biologic. The mean survival of b-DMARD was
82 months (SD±7.4). Causes of suspension were inefficacy (43%), lack of provision
(28.6%), side effects (14.3%), and others. The LUNDEX for the first biologic was 24.7% at
6 months and 44.3% at 1 year. The mean survival of ADA was 90 months (SD±10.4) and
for ETN 79 months (SD±12). Older patients (>55 years old) and obese patients (BMI ≥30)
had less drug survival. In the Cox’s regression analysis, after adjusting for different
confounders, older age was the main variable associated with less drug survival: HR=1.064
(CI=1.01-1.11) (figure 1). LUNDEX was lower in obese vs non-obese patients, 16% vs
66% at 1 year, 10.5 vs 74.9% at 2 years and 5.9 vs 81.8% at 3 years.
Conclusion: The mean survival of the first biologic was 82 months. Older age and obesity
were associated with lower survival of biologic therapy.
Figure 1: Drug survival of patients less than 55 years older and older than 55 years old.
Disclosure: M. N. Fornaro, None; F. Dal Pra, None; E. E. Schneeberger, None; O. L. Cerda, None; M. Landi, None; M. D. L. A. Correa, None; R. Garcia Salinas, None; S. Magri, None; R. Sueldo, None; M. J. Santa Cruz, None; E. Buschiazzo, None; G. Citera, Novartis, Pfizer Inc, 2,AbbVie, Bristol-Myers Squibb, Janssen, Novartis, Pfizer Inc, 5.
To cite this abstract in AMA style:
Fornaro MN, Dal Pra F, Schneeberger EE, Cerda OL, Landi M, Correa MDLA, Garcia Salinas R, Magri S, Sueldo R, Santa Cruz MJ, Buschiazzo E, Citera G. Treatment Patterns, Survival and Long-Term Effectiveness of Biological Agents in Psoriatic Arthritis Patients [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/treatment-patterns-survival-and-long-term-effectiveness-of-biological-agents-in-psoriatic-arthritis-patients/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/treatment-patterns-survival-and-long-term-effectiveness-of-biological-agents-in-psoriatic-arthritis-patients/