Naïve vs. switchers differences in treatment effectiveness in spondyloarthritis

Abstract

Introduction. Treat-to-target concept in spondyloarthritis (SpA) is a highly disputed subject. Up to the present, there is no evaluation score that integrates the clinical and laboratory/imaging results for defining remission in SpA. This issue generates the need of identifying predictive factors of remission in SpA patients. Aim. The aim of this study is to assess the effectiveness of the biological treatment upon naïve patients versus switchers and to identify some difficulties in achieving remission. Material and method. 65 patients with SpA were enrolled in this retrospective study, using data from multiple-choice forms and medical reports from University Hospitals in Romania, between 2019-2021. Results. 65 patients with SpA, in treatment with one biological disease-modifying antirheumatic drug (bDMARD) were available for the baseline analysis. They were distributed into 3 groups, whether they changed the biological therapy: group 1 – naïve patients, group 2 – first-time switchers and group 3 – more than one-time switchers. BASDAI and ASDAS were calculated at baseline, 24 and 52 weeks for the 3 groups. The scores were higher for the switchers and the highest in the 3rd group. Retention time of the first bDMARD was compared between groups and between the biological therapies. Conclusions. Results showed that the best treatment response, as well as effectiveness, is reached by the naïve patients group. Greater retention time rate for the first bDMARD is associated with a greater chance of achieving remission.