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Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome.
J Rheumatol 2015; 42(12):2376-82JR

Abstract

OBJECTIVE

The purpose of this study was to (1) evaluate baseline characteristics of nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) treated with tumor necrosis factor-α inhibitors (TNFi), (2) assess the response to first TNFi treatment, and (3) compare drug-survival duration and rates.

METHODS

Inclusion criteria were patients with axSpA who initiated first TNFi treatment between April 2001 and July 2014 and were followed up for at least 3 months. Efficacy criteria were an improvement of at least 2 points (on a 0-10 scale) or a 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Baseline characteristics, responses at 12 months, and drug survival were compared between AS and nr-axSpA.

RESULTS

A total of 361 patients were included in the study (AS, n = 263 and nr-axSpA, n = 98). Patients with AS were more often men (65.02% vs 45.92%, p = 0.001) and had longer symptom duration (11.71 ± 9.52 vs 7.34 ± 9.30 yrs, p < 0.001). Median levels of acute-phase reactants (C-reactive protein and erythrocyte sedimentation rate) were significantly higher in patients with AS (p < 0.001 for both). Median BASDAI scores at first TNFi initiation were not higher in patients with nr-axSpA than in patients with AS (59, 49-70 vs 60, 50-70, p = 0.73). BASDAI 20 and BASDAI 50 response rates at 12 months were not statistically different between patients with AS and patients with nr-axSpA (74.58% vs 64.58%, p = 0.19 and 61.02% vs 50.00%, p = 0.19, respectively). No statistically significant difference in terms of survival was observed between patients with AS and nr-axSpA (p = 1.00).

CONCLUSION

Treatment response and drug survival were similar in patients with AS and nr-axSpA after first TNFi initiation.

Authors+Show Affiliations

From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital. julienpaccou@yahoo.fr.

Pub Type(s)

Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26568593

Citation

Corli, Justine, et al. "Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome." The Journal of Rheumatology, vol. 42, no. 12, 2015, pp. 2376-82.
Corli J, Flipo RM, Philippe P, et al. Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome. J Rheumatol. 2015;42(12):2376-82.
Corli, J., Flipo, R. M., Philippe, P., Bera-Louville, A., Béhal, H., Wibaux, C., & Paccou, J. (2015). Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome. The Journal of Rheumatology, 42(12), pp. 2376-82. doi:10.3899/jrheum.150372.
Corli J, et al. Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome. J Rheumatol. 2015;42(12):2376-82. PubMed PMID: 26568593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome. AU - Corli,Justine, AU - Flipo,René-Marc, AU - Philippe,Peggy, AU - Bera-Louville,Anne, AU - Béhal,Hélène, AU - Wibaux,Cécile, AU - Paccou,Julien, Y1 - 2015/11/15/ PY - 2015/08/28/accepted PY - 2015/11/17/entrez PY - 2015/11/17/pubmed PY - 2016/9/15/medline KW - ANKYLOSING SPONDYLITIS KW - DRUG SURVIVAL KW - NONRADIOGRAPHIC AXIAL SPONDYLOARTHRITIS KW - TNF-α INHIBITION KW - TREATMENT RESPONSE SP - 2376 EP - 82 JF - The Journal of rheumatology JO - J. Rheumatol. VL - 42 IS - 12 N2 - OBJECTIVE: The purpose of this study was to (1) evaluate baseline characteristics of nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) treated with tumor necrosis factor-α inhibitors (TNFi), (2) assess the response to first TNFi treatment, and (3) compare drug-survival duration and rates. METHODS: Inclusion criteria were patients with axSpA who initiated first TNFi treatment between April 2001 and July 2014 and were followed up for at least 3 months. Efficacy criteria were an improvement of at least 2 points (on a 0-10 scale) or a 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Baseline characteristics, responses at 12 months, and drug survival were compared between AS and nr-axSpA. RESULTS: A total of 361 patients were included in the study (AS, n = 263 and nr-axSpA, n = 98). Patients with AS were more often men (65.02% vs 45.92%, p = 0.001) and had longer symptom duration (11.71 ± 9.52 vs 7.34 ± 9.30 yrs, p < 0.001). Median levels of acute-phase reactants (C-reactive protein and erythrocyte sedimentation rate) were significantly higher in patients with AS (p < 0.001 for both). Median BASDAI scores at first TNFi initiation were not higher in patients with nr-axSpA than in patients with AS (59, 49-70 vs 60, 50-70, p = 0.73). BASDAI 20 and BASDAI 50 response rates at 12 months were not statistically different between patients with AS and patients with nr-axSpA (74.58% vs 64.58%, p = 0.19 and 61.02% vs 50.00%, p = 0.19, respectively). No statistically significant difference in terms of survival was observed between patients with AS and nr-axSpA (p = 1.00). CONCLUSION: Treatment response and drug survival were similar in patients with AS and nr-axSpA after first TNFi initiation. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/26568593/Tumor_Necrosis_Factor_α_Inhibition_in_Ankylosing_Spondylitis_and_Nonradiographic_Axial_Spondyloarthritis:_Treatment_Response_Drug_Survival_and_Patient_Outcome_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&amp;pmid=26568593 DB - PRIME DP - Unbound Medicine ER -