RESEARCH - Efficacy and safety of anti-TNF therapies in psoriatic arthritis: British Society for Rheumatology Biologics Register

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Rheumatology Advance Access published online on January 7, 2010

Rheumatology, doi:10.1093/rheumatology/kep423

Efficacy and safety of anti-TNF therapies in psoriatic arthritis: an

observational study from the British Society for Rheumatology

Biologics Register

Amr A. Saad1, Darren M. Ashcroft1, Kath D. 2, Deborah P. M.

Symmons2, R. Noyce1, Kimme L. Hyrich2 on behalf of the BSRBR

1School of Pharmacy and Pharmaceutical Sciences and 2Arthritis

Research Campaign (ARC) Epidemiology Unit, University of Manchester,

Manchester, UK.

Abstract

Objectives. To evaluate the risk–benefit profile of anti-TNF therapies

in PsA and to study the predictors of treatment response and disease

remission [disease activity score (DAS)-28 < 2.6].

Methods. The study included PsA patients (n = 596) registered with the

British Society for Rheumatology Biologics Register (BSRBR). Response

was assessed using the European League against Rheumatism (EULAR)

improvement criteria. Univariate and multivariate logistic regression

models were developed to examine factors associated with EULAR

response and disease remission using a range of covariates. Poisson

regression was used to calculate incidence rate ratios (IRRs) for

serious adverse events (SAEs) vs seronegative RA controls receiving

DMARDs, adjusting for age, sex and baseline co-morbidity.

Results. At baseline, the mean (S.D.) DAS-28 was 6.4 (5.6). Of the

patients, 70.3% were EULAR responders at 12 months. At 6 months, older

patients [adjusted odds ratio (OR) 0.97 per year; 95% CI 0.95, 0.99],

females (adjusted OR 0.51; 95% CI 0.34, 0.78) and patients on

corticosteroids (adjusted OR 0.45; 95% CI 0.28, 0.72) were less likely

to achieve a EULAR response. Over 1776.2 person-years of follow-up

(median 3.07 per person), the IRR of SAEs compared with controls was

not increased (0.9; 95% CI 0.8, 1.3).

Conclusions. Anti-TNF therapies have a good response rate in PsA, and

have an adverse event profile similar to that seen in a control cohort

of patients with seronegative arthritis receiving DMARD therapy.

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http://rheumatology.oxfordjournals.org/cgi/content/abstract/kep432v1?papetoc

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