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Erschienen in: Clinical Rheumatology 9/2020

18.03.2020 | Original Article

Retention rates and identification of factors associated with anti-TNFα, anti-IL17, and anti-IL12/23R agents discontinuation in psoriatic arthritis patients: results from a real-world clinical setting

verfasst von: Luca Navarini, Luisa Costa, Marco Tasso, Maria Sole Chimenti, Damiano Currado, Giulia Lavinia Fonti, Massimo Ciccozzi, Domenico Paolo Emanuele Margiotta, Carolina Benigno, Erica De Martino, Roberto Perricone, Antonella Afeltra, Raffaele Scarpa, Francesco Caso

Erschienen in: Clinical Rheumatology | Ausgabe 9/2020

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Abstract

Introduction

Biologic disease-modifying antirheumatic drugs (bDMARDs) play a pivotal role in the treatment of psoriatic arthritis (PsA). Despite this, their discontinuation due to inefficacy or adverse events is often observed. The aims of this study are to describe retention rates and treatment trends of anti-TNFα, anti-IL17, and anti-IL12/23R agents in patients with PsA and to identify factors associated with bDMARDs discontinuation in a real-world clinical setting.

Methods

A retrospective cohort study based on the analysis of the three Italian prescription cohorts of patients with PsA has been performed. Survival analysis was performed using Kaplan-Meier curves and Cox proportional-hazards model.

Results

During the follow up, which lasted 25.5 (12–60) months, 68 patients discontinued a bDMARD: 13 for primary failure, 12 for secondary failure, 15 for adverse events, 5 for remission, 12 because of lost at follow-up, and 11 for other causes. Cox proportional-hazards demonstrated that a shorter disease duration (HR 0.994991, 95% CI 0.9910336–0.9989647, p = 0.014) and first-line bDMARD (HR 0.5090986, 95% CI 0.3073519–0.8432722, p = 0.009) have a protective role on bDMARD retention rate, while the multivariable analysis failed in demonstrating an independent protective role of male sex on drug retention rate (p = 0.083). No significant differences in retention rate have been found regarding biologic drugs, combination therapy or monotherapy, and class of bDMARD (anti-TNFα or anti-pIL12/23R and anti-IL-17).

Conclusions

This study shows that a shorter disease duration and treatment with a first-line bDMARD are predictors of bDMARDs retention rate, further highlighting the importance of early diagnosis of PsA.
Key Points
• No significant difference in retention among patients treated with anti-IL17A, anti-IL12/23R, and anti-TNFα agents has been demonstrated.
• A shorter disease duration and first-line bDMARD treatment are associated with persistence in biologic treatment.
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Metadaten
Titel
Retention rates and identification of factors associated with anti-TNFα, anti-IL17, and anti-IL12/23R agents discontinuation in psoriatic arthritis patients: results from a real-world clinical setting
verfasst von
Luca Navarini
Luisa Costa
Marco Tasso
Maria Sole Chimenti
Damiano Currado
Giulia Lavinia Fonti
Massimo Ciccozzi
Domenico Paolo Emanuele Margiotta
Carolina Benigno
Erica De Martino
Roberto Perricone
Antonella Afeltra
Raffaele Scarpa
Francesco Caso
Publikationsdatum
18.03.2020
Verlag
Springer International Publishing
Erschienen in
Clinical Rheumatology / Ausgabe 9/2020
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-020-05027-1

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