Tumour necrosis factor inhibitor survival and predictors of response in axial spondyloarthritis-findings from a United Kingdom cohort

Fariz Yahya, Karl Gaffney, Louise Hamilton, Ellie Lonsdale, Jane Leeder, Alan Brooksby, Charlotte Cavill, Joshua Berry-Jenkins, Cathal Boyle, Debbie Bond, Raj Sengupta, BRITSpA

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives. To analyse long-term survival and efficacy of TNFi, reasons for switching or discontinuing, baseline predictors of response and remission in axial spondyloarthritis (axSpA) patients in a UK cohort. Methods. All patients with a physician-verified diagnosis of axSpA attending two specialist centres who fulfilled the eligibility criteria for TNFi were included. Routinely recorded patient data were reviewed retrospectively. Initial TNFi was recorded as the index drug. Results. Six hundred and fifty-one patients (94% AS) were included; adalimumab (n = 332), etanercept (n = 205), infliximab (n = 51), golimumab (n = 40) and certolizumab pegol (n = 23) were index TNFi. The mean (S.D.) duration from symptom onset to time of diagnosis was 8.6 (8.7) years and mean (S.D.) duration from diagnosis to TNFi initiation was 12.6 (11.5) years. A total of 224 (34.4%) stopped index TNFi, and 105/224 switched to a second TNFi. Median drug survival for index and second TNFi were 10.2 years (95% CI: 8.8, 11.6 years) and 5.5 years (95% CI: 2.7, 8.3 years), respectively (P < 0.05). Survival rates were not influenced by choice of TNFi. HLA-B27 predicted BASDAI50 and/or two or more point reduction within 6 months and long-term drug survival (P < 0.05). Low disease activity was predicted by non-smoking and low baseline BASDAI (P < 0.05). Conclusion. We have observed good TNFi survival rates in axSpA patients treated in a real-life setting. This is best for first TNFi and not influenced by drug choice.

Original languageEnglish
Pages (from-to)619–624
Number of pages6
JournalRheumatology
Volume57
Issue number4
Early online date20 Dec 2017
DOIs
Publication statusPublished - 1 Apr 2018

Fingerprint

Tumor Necrosis Factor-alpha
Survival
Pharmaceutical Preparations
Survival Rate
HLA-B27 Antigen
United Kingdom
Physicians

Keywords

  • Journal Article
  • Axial spondyloarthritis
  • TNF inhibitors
  • Drug survival
  • Predictors
  • Humans
  • Male
  • Drug Substitution/methods
  • Incidence
  • Dose-Response Relationship, Drug
  • Tumor Necrosis Factor-alpha/antagonists & inhibitors
  • Young Adult
  • Adult
  • Female
  • Retrospective Studies
  • Adalimumab/therapeutic use
  • Infliximab/administration & dosage
  • Certolizumab Pegol/administration & dosage
  • Treatment Outcome
  • Antirheumatic Agents/administration & dosage
  • Withholding Treatment
  • Antibodies, Monoclonal/administration & dosage
  • Forecasting
  • United Kingdom/epidemiology
  • Remission Induction/methods
  • Spondylarthritis/diagnosis
  • Etanercept/administration & dosage

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Rheumatology

Cite this

Tumour necrosis factor inhibitor survival and predictors of response in axial spondyloarthritis-findings from a United Kingdom cohort. / Yahya, Fariz; Gaffney, Karl; Hamilton, Louise; Lonsdale, Ellie; Leeder, Jane; Brooksby, Alan; Cavill, Charlotte; Berry-Jenkins, Joshua; Boyle, Cathal; Bond, Debbie; Sengupta, Raj; BRITSpA.

In: Rheumatology, Vol. 57, No. 4, 01.04.2018, p. 619–624.

Research output: Contribution to journalArticle

Yahya, F, Gaffney, K, Hamilton, L, Lonsdale, E, Leeder, J, Brooksby, A, Cavill, C, Berry-Jenkins, J, Boyle, C, Bond, D, Sengupta, R & BRITSpA 2018, 'Tumour necrosis factor inhibitor survival and predictors of response in axial spondyloarthritis-findings from a United Kingdom cohort', Rheumatology, vol. 57, no. 4, pp. 619–624. https://doi.org/10.1093/rheumatology/kex457
Yahya, Fariz ; Gaffney, Karl ; Hamilton, Louise ; Lonsdale, Ellie ; Leeder, Jane ; Brooksby, Alan ; Cavill, Charlotte ; Berry-Jenkins, Joshua ; Boyle, Cathal ; Bond, Debbie ; Sengupta, Raj ; BRITSpA. / Tumour necrosis factor inhibitor survival and predictors of response in axial spondyloarthritis-findings from a United Kingdom cohort. In: Rheumatology. 2018 ; Vol. 57, No. 4. pp. 619–624.
@article{f4002ee8e65b4556a68974a2e3e4d6ab,
title = "Tumour necrosis factor inhibitor survival and predictors of response in axial spondyloarthritis-findings from a United Kingdom cohort",
abstract = "Objectives. To analyse long-term survival and efficacy of TNFi, reasons for switching or discontinuing, baseline predictors of response and remission in axial spondyloarthritis (axSpA) patients in a UK cohort. Methods. All patients with a physician-verified diagnosis of axSpA attending two specialist centres who fulfilled the eligibility criteria for TNFi were included. Routinely recorded patient data were reviewed retrospectively. Initial TNFi was recorded as the index drug. Results. Six hundred and fifty-one patients (94{\%} AS) were included; adalimumab (n = 332), etanercept (n = 205), infliximab (n = 51), golimumab (n = 40) and certolizumab pegol (n = 23) were index TNFi. The mean (S.D.) duration from symptom onset to time of diagnosis was 8.6 (8.7) years and mean (S.D.) duration from diagnosis to TNFi initiation was 12.6 (11.5) years. A total of 224 (34.4{\%}) stopped index TNFi, and 105/224 switched to a second TNFi. Median drug survival for index and second TNFi were 10.2 years (95{\%} CI: 8.8, 11.6 years) and 5.5 years (95{\%} CI: 2.7, 8.3 years), respectively (P < 0.05). Survival rates were not influenced by choice of TNFi. HLA-B27 predicted BASDAI50 and/or two or more point reduction within 6 months and long-term drug survival (P < 0.05). Low disease activity was predicted by non-smoking and low baseline BASDAI (P < 0.05). Conclusion. We have observed good TNFi survival rates in axSpA patients treated in a real-life setting. This is best for first TNFi and not influenced by drug choice.",
keywords = "Journal Article, Axial spondyloarthritis, TNF inhibitors, Drug survival, Predictors, Humans, Male, Drug Substitution/methods, Incidence, Dose-Response Relationship, Drug, Tumor Necrosis Factor-alpha/antagonists & inhibitors, Young Adult, Adult, Female, Retrospective Studies, Adalimumab/therapeutic use, Infliximab/administration & dosage, Certolizumab Pegol/administration & dosage, Treatment Outcome, Antirheumatic Agents/administration & dosage, Withholding Treatment, Antibodies, Monoclonal/administration & dosage, Forecasting, United Kingdom/epidemiology, Remission Induction/methods, Spondylarthritis/diagnosis, Etanercept/administration & dosage",
author = "Fariz Yahya and Karl Gaffney and Louise Hamilton and Ellie Lonsdale and Jane Leeder and Alan Brooksby and Charlotte Cavill and Joshua Berry-Jenkins and Cathal Boyle and Debbie Bond and Raj Sengupta and BRITSpA",
note = "{\circledC} The Author(s) 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com",
year = "2018",
month = "4",
day = "1",
doi = "10.1093/rheumatology/kex457",
language = "English",
volume = "57",
pages = "619–624",
journal = "Rheumatology",
issn = "1462-0324",
publisher = "Oxford University Press",
number = "4",

}

TY - JOUR

T1 - Tumour necrosis factor inhibitor survival and predictors of response in axial spondyloarthritis-findings from a United Kingdom cohort

AU - Yahya, Fariz

AU - Gaffney, Karl

AU - Hamilton, Louise

AU - Lonsdale, Ellie

AU - Leeder, Jane

AU - Brooksby, Alan

AU - Cavill, Charlotte

AU - Berry-Jenkins, Joshua

AU - Boyle, Cathal

AU - Bond, Debbie

AU - Sengupta, Raj

AU - BRITSpA

N1 - © The Author(s) 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Objectives. To analyse long-term survival and efficacy of TNFi, reasons for switching or discontinuing, baseline predictors of response and remission in axial spondyloarthritis (axSpA) patients in a UK cohort. Methods. All patients with a physician-verified diagnosis of axSpA attending two specialist centres who fulfilled the eligibility criteria for TNFi were included. Routinely recorded patient data were reviewed retrospectively. Initial TNFi was recorded as the index drug. Results. Six hundred and fifty-one patients (94% AS) were included; adalimumab (n = 332), etanercept (n = 205), infliximab (n = 51), golimumab (n = 40) and certolizumab pegol (n = 23) were index TNFi. The mean (S.D.) duration from symptom onset to time of diagnosis was 8.6 (8.7) years and mean (S.D.) duration from diagnosis to TNFi initiation was 12.6 (11.5) years. A total of 224 (34.4%) stopped index TNFi, and 105/224 switched to a second TNFi. Median drug survival for index and second TNFi were 10.2 years (95% CI: 8.8, 11.6 years) and 5.5 years (95% CI: 2.7, 8.3 years), respectively (P < 0.05). Survival rates were not influenced by choice of TNFi. HLA-B27 predicted BASDAI50 and/or two or more point reduction within 6 months and long-term drug survival (P < 0.05). Low disease activity was predicted by non-smoking and low baseline BASDAI (P < 0.05). Conclusion. We have observed good TNFi survival rates in axSpA patients treated in a real-life setting. This is best for first TNFi and not influenced by drug choice.

AB - Objectives. To analyse long-term survival and efficacy of TNFi, reasons for switching or discontinuing, baseline predictors of response and remission in axial spondyloarthritis (axSpA) patients in a UK cohort. Methods. All patients with a physician-verified diagnosis of axSpA attending two specialist centres who fulfilled the eligibility criteria for TNFi were included. Routinely recorded patient data were reviewed retrospectively. Initial TNFi was recorded as the index drug. Results. Six hundred and fifty-one patients (94% AS) were included; adalimumab (n = 332), etanercept (n = 205), infliximab (n = 51), golimumab (n = 40) and certolizumab pegol (n = 23) were index TNFi. The mean (S.D.) duration from symptom onset to time of diagnosis was 8.6 (8.7) years and mean (S.D.) duration from diagnosis to TNFi initiation was 12.6 (11.5) years. A total of 224 (34.4%) stopped index TNFi, and 105/224 switched to a second TNFi. Median drug survival for index and second TNFi were 10.2 years (95% CI: 8.8, 11.6 years) and 5.5 years (95% CI: 2.7, 8.3 years), respectively (P < 0.05). Survival rates were not influenced by choice of TNFi. HLA-B27 predicted BASDAI50 and/or two or more point reduction within 6 months and long-term drug survival (P < 0.05). Low disease activity was predicted by non-smoking and low baseline BASDAI (P < 0.05). Conclusion. We have observed good TNFi survival rates in axSpA patients treated in a real-life setting. This is best for first TNFi and not influenced by drug choice.

KW - Journal Article

KW - Axial spondyloarthritis

KW - TNF inhibitors

KW - Drug survival

KW - Predictors

KW - Humans

KW - Male

KW - Drug Substitution/methods

KW - Incidence

KW - Dose-Response Relationship, Drug

KW - Tumor Necrosis Factor-alpha/antagonists & inhibitors

KW - Young Adult

KW - Adult

KW - Female

KW - Retrospective Studies

KW - Adalimumab/therapeutic use

KW - Infliximab/administration & dosage

KW - Certolizumab Pegol/administration & dosage

KW - Treatment Outcome

KW - Antirheumatic Agents/administration & dosage

KW - Withholding Treatment

KW - Antibodies, Monoclonal/administration & dosage

KW - Forecasting

KW - United Kingdom/epidemiology

KW - Remission Induction/methods

KW - Spondylarthritis/diagnosis

KW - Etanercept/administration & dosage

UR - http://www.scopus.com/inward/record.url?scp=85045065746&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/kex457

DO - 10.1093/rheumatology/kex457

M3 - Article

VL - 57

SP - 619

EP - 624

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 4

ER -