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@article{1773197,
author = {Thomas, M. L. and Shaddick, G. and Charlton, R. and Cavill, C. and Holland, R. and Iannone, F. and Lapadula, G. and Lopriore, S. and Zavada, J. and Uher, Michal and Pavelka, Karel and Szczuková, Lenka and Sidiropoulos, P. and Flouri, I. and Drosos, A. and Moller, B. and Nissen, M. J. and Muller, R. B. and Scherer, A. and McHugh, N. and Nightingale, A.},
article_location = {TORONTO},
article_number = {1},
doi = {http://dx.doi.org/10.3899/jrheum.190815},
keywords = {comparative effectiveness; drug survival; methotrexate; psoriatic arthritis; TNF inhibitor},
language = {eng},
issn = {0315-162X},
journal = {The Journal of Rheumatology},
title = {Tumor Necrosis Factor Inhibitor Monotherapy Versus Combination Therapy for the Treatment of Psoriatic Arthritis: Combined Analysis of European Biologics Databases},
url = {https://www.jrheum.org/content/48/1/48},
volume = {48},
year = {2021}
}
TY - JOUR
ID - 1773197
AU - Thomas, M. L. - Shaddick, G. - Charlton, R. - Cavill, C. - Holland, R. - Iannone, F. - Lapadula, G. - Lopriore, S. - Zavada, J. - Uher, Michal - Pavelka, Karel - Szczuková, Lenka - Sidiropoulos, P. - Flouri, I. - Drosos, A. - Moller, B. - Nissen, M. J. - Muller, R. B. - Scherer, A. - McHugh, N. - Nightingale, A.
PY - 2021
TI - Tumor Necrosis Factor Inhibitor Monotherapy Versus Combination Therapy for the Treatment of Psoriatic Arthritis: Combined Analysis of European Biologics Databases
JF - The Journal of Rheumatology
VL - 48
IS - 1
SP - 48-57
EP - 48-57
PB - J RHEUMATOL PUBL CO
SN - 0315162X
KW - comparative effectiveness
KW - drug survival
KW - methotrexate
KW - psoriatic arthritis
KW - TNF inhibitor
UR - https://www.jrheum.org/content/48/1/48
N2 - Objective. To investigate whether tumor necrosis factor inhibitor ( TNFi) combination therapy with conventional synthetic disease-modifying antirheumatic drugs (csDMARD) is more effective for psoriatic arthritis (PsA) and/or improves TNFi drug survival compared to TNFi monotherapy. Methods. Five PsA biologics cohorts were investigated between 2000 and 2015: the ATTRA registry (Czech Republic); the Swiss Clinical Quality Management PsA registry; the Hellenic Registry of Biologics Therapies (Greece); the University of Bari PsA biologics database (Italy); and the Bath PsA cohort (UK). Drug persistence was analyzed using Kaplan-Meier and equality of survival using log-rank tests. Comparative effectiveness was investigated using logistic regression with propensity scores. Separate analyses were performed on (1) the combined Italian/Swiss cohorts for change in rate of Disease Activity Score in 28 joints (DAS28); and (2) the combined Italian, Swiss, and Bath cohorts for change in rate of Health Assessment Questionnaire (HAQ). Results. In total, 2294 patients were eligible for the drug survival analysis. In the Swiss (P = 0.002), Greek (P = 0.021), and Bath (P = 0.014) databases, patients starting TNFi in combination with methotrexate had longer drug survival compared to monotherapy, while in Italy the monotherapy group persisted longer (P = 0.030). In eligible patients from the combined Italian/Swiss dataset (n = 1056), there was no significant difference between treatment arms in rate of change of DAS28. Similarly, when also including the Bath cohort (n = 1205), there was no significant difference in rate of change of HAQ. Conclusion. Combination therapy of a TNFi with a csDMARD does not appear to affect improvement of disease activity or HAQ versus TNFi monotherapy, but it may improve TNFi drug survival.
ER -
THOMAS, M. L., G. SHADDICK, R. CHARLTON, C. CAVILL, R. HOLLAND, F. IANNONE, G. LAPADULA, S. LOPRIORE, J. ZAVADA, Michal UHER, Karel PAVELKA, Lenka SZCZUKOVÁ, P. SIDIROPOULOS, I. FLOURI, A. DROSOS, B. MOLLER, M. J. NISSEN, R. B. MULLER, A. SCHERER, N. MCHUGH and A. NIGHTINGALE. Tumor Necrosis Factor Inhibitor Monotherapy Versus Combination Therapy for the Treatment of Psoriatic Arthritis: Combined Analysis of European Biologics Databases. \textit{The Journal of Rheumatology}. TORONTO: J RHEUMATOL PUBL CO, 2021, vol.~48, No~1, p.~48-57. ISSN~0315-162X. Available from: https://dx.doi.org/10.3899/jrheum.190815.
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