Abstract
Background The efficacy of Tumour Necrosis Factor inhibitor (TNFi) in patients with psoriatic arthritis (PsA) has been investigated in randomized controlled trials (RCTs) with strict inclusion and exclusion criteria. Patients treated in routine care are more heterogeneous and only ≈20-30% of patients receiving TNFi in routine care would have been eligible to be enrolled in the RCTs1. This emphasizes the need for real-world observational data as a valuable supplement to RCTs. Studying large patient groups from several European countries would increase the external validity of the results. Objectives To investigate Tumour Necrosis Factor inhibitor (TNFi) retention rates at 12 months (primary objective), 6 and 24 months, and remission rates at the same time-points in biologic-naive patients with PsA from the EuroSpA Collaboration. Methods Prospectively collected data on PsA patients from 12 European registries were uploaded through the secure Virtual Private Network pipelines to the EuroSpA server, and pooled. Baseline characteristics were investigated with non-parametric descriptive statistics. TNFi retention rates (Kaplan-Meier statistics), and 28-joint count Disease activity Score (DAS28) Results Overall, 14,261 patients with PsA initiated a 1st TNFi. Baseline characteristics of the pooled population are shown in the Table. The median 12-month retention rate (95%CI) was 77% (76-78%), ranging from 68-90% across registries (Figure). Overall, DAS28/DAPSA28 remission rates at 6 months were 56%/27% (LUNDEX-adjusted: 45%/22%). In patients initiating a 1stTNFi after 2009 with registered fulfillment of CASPAR criteria (n=1,980) or registered ≥1 swollen joint at baseline (n=5,803), the retention rates and remission rates were similar to those found overall (Table). Conclusion Approximately half of >14,000 patients with PsA who initiated 1st TNFi treatment in routine care were in DAS28-remission after 6 months, and three out of four were still on the drug after 1 year.
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