Long-term effectiveness of tumour necrosis factor-α inhibitor treatment for psoriatic arthritis in the UK

A multicentre retrospective study

Gavin Clunie, Iain B. McInnes, Nick Barkham, Helena Marzo-Ortega, Yusuf Patel, Andrew Gough, Jon Packham, Stuart Kyle, Bruce Kirkham, Tom Sheeran, Helen Coope, Anna Bishop-Bailey, Neil McHugh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective. Real-world evidence of the long-term effectiveness of TNF-α inhibitor (TNFi) therapy in patients with PsA is limited. This study was conducted to describe patterns of TNFi therapy and treatment responses in patients with PsA treated in UK clinical practice. Methods. A multicentre, retrospective, observational cohort study of consenting patients treated with TNFi for PsA with ≥ 3 years follow-up from first TNFi initiation (observation period) was carried out in 11 UK National Health Service hospitals. Data were collected concerning baseline patient characteristics, PsA-related treatment pathways and TNFi treatment responses (PsA response criteria components: swollen/tender joint counts, physician and patient global assessments). Results. The mean age of patients (n=141) was 50.3 (S.D.: 12.1) years (50% male). During a median observation period of 4.5 (range: 3.4-5.5) years, patients received a median of one (range: one to five) TNFi. Twelve-week response rates for first TNFi (where available) were as follows: 80% (n=64/80) for swollen joint counts, 79% (n=63/79) for tender joint counts, 79% (n=37/47) for physician global assessments, 69% (n=41/59) for patient global assessments and 79% (n=37/47) for PsA response criteria. At the end of the observation period, the proportions of patients remaining on first, second, third and fourth/fifth TNFi were 56, 15, 5 and 3%, respectively; 21% of patients permanently discontinued TNFi therapy. Conclusion. Long-term TNFi therapy is generally well tolerated and may be effective; however, after initial TNFi failure, there appears to be progressively less benefit and more adverse effects with successive TNFi switches. Strategies are needed for effective therapy for PsA beyond the first TNFi failure.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalRheumatology Advances in Practice
Volume2
Issue number2
DOIs
Publication statusPublished - 2018

Keywords

  • Observational study
  • Patient global assessment
  • Physician global assessment
  • Psoriatic arthritis
  • Swollen joints
  • Tender joints
  • Treatment persistence
  • Tumour necrosis factor inhibitors

ASJC Scopus subject areas

  • Rheumatology

Cite this

Long-term effectiveness of tumour necrosis factor-α inhibitor treatment for psoriatic arthritis in the UK : A multicentre retrospective study. / Clunie, Gavin; McInnes, Iain B.; Barkham, Nick; Marzo-Ortega, Helena; Patel, Yusuf; Gough, Andrew; Packham, Jon; Kyle, Stuart; Kirkham, Bruce; Sheeran, Tom; Coope, Helen; Bishop-Bailey, Anna; McHugh, Neil.

In: Rheumatology Advances in Practice, Vol. 2, No. 2, 2018, p. 1-11.

Research output: Contribution to journalArticle

Clunie, G, McInnes, IB, Barkham, N, Marzo-Ortega, H, Patel, Y, Gough, A, Packham, J, Kyle, S, Kirkham, B, Sheeran, T, Coope, H, Bishop-Bailey, A & McHugh, N 2018, 'Long-term effectiveness of tumour necrosis factor-α inhibitor treatment for psoriatic arthritis in the UK: A multicentre retrospective study', Rheumatology Advances in Practice, vol. 2, no. 2, pp. 1-11. https://doi.org/10.1093/rap/rky042
Clunie, Gavin ; McInnes, Iain B. ; Barkham, Nick ; Marzo-Ortega, Helena ; Patel, Yusuf ; Gough, Andrew ; Packham, Jon ; Kyle, Stuart ; Kirkham, Bruce ; Sheeran, Tom ; Coope, Helen ; Bishop-Bailey, Anna ; McHugh, Neil. / Long-term effectiveness of tumour necrosis factor-α inhibitor treatment for psoriatic arthritis in the UK : A multicentre retrospective study. In: Rheumatology Advances in Practice. 2018 ; Vol. 2, No. 2. pp. 1-11.
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abstract = "Objective. Real-world evidence of the long-term effectiveness of TNF-α inhibitor (TNFi) therapy in patients with PsA is limited. This study was conducted to describe patterns of TNFi therapy and treatment responses in patients with PsA treated in UK clinical practice. Methods. A multicentre, retrospective, observational cohort study of consenting patients treated with TNFi for PsA with ≥ 3 years follow-up from first TNFi initiation (observation period) was carried out in 11 UK National Health Service hospitals. Data were collected concerning baseline patient characteristics, PsA-related treatment pathways and TNFi treatment responses (PsA response criteria components: swollen/tender joint counts, physician and patient global assessments). Results. The mean age of patients (n=141) was 50.3 (S.D.: 12.1) years (50{\%} male). During a median observation period of 4.5 (range: 3.4-5.5) years, patients received a median of one (range: one to five) TNFi. Twelve-week response rates for first TNFi (where available) were as follows: 80{\%} (n=64/80) for swollen joint counts, 79{\%} (n=63/79) for tender joint counts, 79{\%} (n=37/47) for physician global assessments, 69{\%} (n=41/59) for patient global assessments and 79{\%} (n=37/47) for PsA response criteria. At the end of the observation period, the proportions of patients remaining on first, second, third and fourth/fifth TNFi were 56, 15, 5 and 3{\%}, respectively; 21{\%} of patients permanently discontinued TNFi therapy. Conclusion. Long-term TNFi therapy is generally well tolerated and may be effective; however, after initial TNFi failure, there appears to be progressively less benefit and more adverse effects with successive TNFi switches. Strategies are needed for effective therapy for PsA beyond the first TNFi failure.",
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T1 - Long-term effectiveness of tumour necrosis factor-α inhibitor treatment for psoriatic arthritis in the UK

T2 - A multicentre retrospective study

AU - Clunie, Gavin

AU - McInnes, Iain B.

AU - Barkham, Nick

AU - Marzo-Ortega, Helena

AU - Patel, Yusuf

AU - Gough, Andrew

AU - Packham, Jon

AU - Kyle, Stuart

AU - Kirkham, Bruce

AU - Sheeran, Tom

AU - Coope, Helen

AU - Bishop-Bailey, Anna

AU - McHugh, Neil

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N2 - Objective. Real-world evidence of the long-term effectiveness of TNF-α inhibitor (TNFi) therapy in patients with PsA is limited. This study was conducted to describe patterns of TNFi therapy and treatment responses in patients with PsA treated in UK clinical practice. Methods. A multicentre, retrospective, observational cohort study of consenting patients treated with TNFi for PsA with ≥ 3 years follow-up from first TNFi initiation (observation period) was carried out in 11 UK National Health Service hospitals. Data were collected concerning baseline patient characteristics, PsA-related treatment pathways and TNFi treatment responses (PsA response criteria components: swollen/tender joint counts, physician and patient global assessments). Results. The mean age of patients (n=141) was 50.3 (S.D.: 12.1) years (50% male). During a median observation period of 4.5 (range: 3.4-5.5) years, patients received a median of one (range: one to five) TNFi. Twelve-week response rates for first TNFi (where available) were as follows: 80% (n=64/80) for swollen joint counts, 79% (n=63/79) for tender joint counts, 79% (n=37/47) for physician global assessments, 69% (n=41/59) for patient global assessments and 79% (n=37/47) for PsA response criteria. At the end of the observation period, the proportions of patients remaining on first, second, third and fourth/fifth TNFi were 56, 15, 5 and 3%, respectively; 21% of patients permanently discontinued TNFi therapy. Conclusion. Long-term TNFi therapy is generally well tolerated and may be effective; however, after initial TNFi failure, there appears to be progressively less benefit and more adverse effects with successive TNFi switches. Strategies are needed for effective therapy for PsA beyond the first TNFi failure.

AB - Objective. Real-world evidence of the long-term effectiveness of TNF-α inhibitor (TNFi) therapy in patients with PsA is limited. This study was conducted to describe patterns of TNFi therapy and treatment responses in patients with PsA treated in UK clinical practice. Methods. A multicentre, retrospective, observational cohort study of consenting patients treated with TNFi for PsA with ≥ 3 years follow-up from first TNFi initiation (observation period) was carried out in 11 UK National Health Service hospitals. Data were collected concerning baseline patient characteristics, PsA-related treatment pathways and TNFi treatment responses (PsA response criteria components: swollen/tender joint counts, physician and patient global assessments). Results. The mean age of patients (n=141) was 50.3 (S.D.: 12.1) years (50% male). During a median observation period of 4.5 (range: 3.4-5.5) years, patients received a median of one (range: one to five) TNFi. Twelve-week response rates for first TNFi (where available) were as follows: 80% (n=64/80) for swollen joint counts, 79% (n=63/79) for tender joint counts, 79% (n=37/47) for physician global assessments, 69% (n=41/59) for patient global assessments and 79% (n=37/47) for PsA response criteria. At the end of the observation period, the proportions of patients remaining on first, second, third and fourth/fifth TNFi were 56, 15, 5 and 3%, respectively; 21% of patients permanently discontinued TNFi therapy. Conclusion. Long-term TNFi therapy is generally well tolerated and may be effective; however, after initial TNFi failure, there appears to be progressively less benefit and more adverse effects with successive TNFi switches. Strategies are needed for effective therapy for PsA beyond the first TNFi failure.

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