J 2021

Tumor Necrosis Factor Inhibitor Monotherapy Versus Combination Therapy for the Treatment of Psoriatic Arthritis: Combined Analysis of European Biologics Databases

THOMAS, M. L., G. SHADDICK, R. CHARLTON, C. CAVILL, R. HOLLAND et. al.

Basic information

Original name

Tumor Necrosis Factor Inhibitor Monotherapy Versus Combination Therapy for the Treatment of Psoriatic Arthritis: Combined Analysis of European Biologics Databases

Authors

THOMAS, M. L., G. SHADDICK, R. CHARLTON, C. CAVILL, R. HOLLAND, F. IANNONE, G. LAPADULA, S. LOPRIORE, J. ZAVADA, Michal UHER (203 Czech Republic, belonging to the institution), Karel PAVELKA (203 Czech Republic), Lenka SZCZUKOVÁ (203 Czech Republic, belonging to the institution), P. SIDIROPOULOS, I. FLOURI, A. DROSOS, B. MOLLER, M. J. NISSEN, R. B. MULLER, A. SCHERER, N. MCHUGH (guarantor) and A. NIGHTINGALE

Edition

The Journal of Rheumatology, TORONTO, J RHEUMATOL PUBL CO, 2021, 0315-162X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30226 Rheumatology

Country of publisher

Canada

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 5.346

RIV identification code

RIV/00216224:14110/21:00121692

Organization unit

Faculty of Medicine

UT WoS

000604916900009

Keywords in English

comparative effectiveness; drug survival; methotrexate; psoriatic arthritis; TNF inhibitor

Tags

Tags

International impact, Reviewed
Změněno: 2/6/2021 12:55, Mgr. Tereza Miškechová

Abstract

V originále

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.