RESEARCH - The comparative one-year performance of anti-TNF drugs in patients with RA, PsA, and AS

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Arthritis Rheum. 2008 Jan 31;59(2):234-240 [Epub ahead of print]

The comparative one-year performance of anti-tumor necrosis factor

alpha drugs in patients with rheumatoid arthritis, psoriatic

arthritis, and ankylosing spondylitis: Results from a longitudinal,

observational, multicenter study.

Heiberg MS, Koldingsnes W, Mikkelsen K, Rødevand E, Kaufmann C,

Mowinckel P, Kvien TK.

Diakonhjemmet Hospital, Oslo, Norway.

OBJECTIVE: To compare the 1-year retention rates of anti-tumor

necrosis factor alpha (anti-TNFalpha) medications in patients with

rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing

spondylitis (AS) with complementary analyses of the effect on health

status. METHODS: Our analyses comprised 847, 172, and 249

anti-TNFalpha treatment courses in patients with RA, PsA, and AS,

respectively. Crude drug survival was compared and hazard ratios (HRs)

for treatment termination were calculated with adjustments for age,

sex, investigator's global assessment, and concomitant methotrexate

(MTX). Adjusted changes in health-related quality of life (HRQOL) were

compared among the groups. RESULTS: Unadjusted 1-year retention rates

were 65.4%, 77.3%, and 77.5% in the RA, PsA, and AS groups,

respectively. The adjusted HRs for treatment termination were 0.76

(95% confidence interval [95% CI] 0.53-1.07) for PsA versus RA and

0.66 (95% CI 0.47-0.92) for AS versus RA. High baseline disease

activity and female sex were significantly associated with premature

treatment termination, whereas concomitant MTX was associated with

better drug survival. However, the impact of MTX was apparent for RA

and PsA, but not for AS in stratified analyses. The improvements in

HRQOL were superior in patients with PsA and AS compared with RA.

CONCLUSION: Our results suggest that survival of anti-TNFalpha

treatment is superior in AS and PsA patients compared with RA

patients. Larger improvements in HRQOL in patients with

spondylarthritides may contribute to the differences in drug survival.

Concomitant MTX was associated with better retention rates in RA and

PsA patients, but not AS patients.

PMID: 18240258

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve & db=PubMed & list_uids=182402\

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