J 2020

Short-term response in new users of anti-TNF predicts long-term productivity and non-disability: analysis of Czech ATTRA ankylosing spondylitis biologic registry

TUŽIL, Jan, Tomáš MLČOCH, Jitka JIRČÍKOVÁ, Jakub ZÁVADA, Lucie NEKVINDOVÁ et. al.

Basic information

Original name

Short-term response in new users of anti-TNF predicts long-term productivity and non-disability: analysis of Czech ATTRA ankylosing spondylitis biologic registry

Authors

TUŽIL, Jan (203 Czech Republic, guarantor), Tomáš MLČOCH (203 Czech Republic), Jitka JIRČÍKOVÁ (203 Czech Republic), Jakub ZÁVADA (203 Czech Republic), Lucie NEKVINDOVÁ (203 Czech Republic, belonging to the institution), Michal SVOBODA (203 Czech Republic, belonging to the institution), Michal UHER (203 Czech Republic, belonging to the institution), Zlatuše KŘÍSTKOVÁ (203 Czech Republic, belonging to the institution), Jiří VENCOVSKÝ (203 Czech Republic), Karel PAVELKA (203 Czech Republic) and Tomáš DOLEŽAL (203 Czech Republic, belonging to the institution)

Edition

Expert Opinion on Biological Therapy, TAYLOR & FRANCIS, 2020, 1471-2598

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30401 Health-related biotechnology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 4.388

RIV identification code

RIV/00216224:14110/20:00115280

Organization unit

Faculty of Medicine

UT WoS

000498457000001

Keywords in English

Ankylosing spondylitis; BASDAI; ASDAS; anti-TNF; work impairment; disability; predictive power; multivariate modeling

Tags

International impact, Reviewed
Změněno: 27/4/2020 08:11, Mgr. Tereza Miškechová

Abstract

V originále

Objectives: To assess the role of short-term response to first anti-TNF in long-term prediction of disability. Methods: In nationwide registry ATTRA, we identified ankylosing spondylitis patients starting anti-TNF between 01/2003 and 12/2016. Full disability and work impairment (WI; WPAI questionnaire) were predicted via the Cox- and lagged-parameter mixed-effect regression. Results: 2,274 biologicals-naive patients newly indicated to anti-TNF were prospectively followed (6,333 patient-years; median follow-up 1.9 years). Reaching BASDAI < 4 (77.4%) and ASDAS-CRP < 2.1 (61.1%) after 3 months of anti-TNF both decreased the risk of future disability by approximate to 2.5-fold. ASDAS-CRP < 2.1 predicted non-disability better than BASDAI < 4 & CRP < 5 mg/L (p = 0.032). BASDAI < 4 & CRP < 5 mg/L was comparable to BASDAI < 4 (p = 0.941) and to BASDAI change by >50% or by >2 points (p = 0.902). ASDAS-CRP change >1.1 and >2.0 both failed to predict non-disability. Once on anti-TNF therapy, the strongest predictor of WI was Pain (SF36). Yearly increase in indirect costs remains below euro3,000 in those reaching ASDAS-CRP < 2.1. Conclusions: Low disease activity measured by ASDAS-CRP <= 2.1 should be used to measure the outcome of new anti-TNF therapy. Continuous WI could be decreased through pain management.