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The impact of a csD...
The impact of a csDMARD in combination with a TNF inhibitor on drug retention and clinical remission in axial spondylarthritis
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Nissen, M. (author)
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- Delcoigne, B. (author)
- Karolinska Institutet
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- Di Giuseppe, D. (author)
- Karolinska Institutet
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- Jacobsson, Lennart T. H., 1954 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research
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Hetland, M. L. (author)
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Ciurea, A. (author)
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Nekvindova, L. (author)
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Iannone, F. (author)
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Akkoc, N. (author)
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Sokka-Isler, T. (author)
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Fagerli, K. M. (author)
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Santos, M. J. (author)
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Codreanu, C. (author)
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Pombo-Suarez, M. (author)
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Rotar, Z. (author)
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Gudbjornsson, B. (author)
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Van der Horst-Bruinsma, I. (author)
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Loft, A. G. (author)
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Moller, B. (author)
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Mann, H. (author)
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Conti, F. (author)
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Cetin, G. Y. (author)
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Relas, H. (author)
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Michelsen, B. (author)
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Ribeiro, P. A. (author)
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Ionescu, R. (author)
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Sanchez-Piedra, C. (author)
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Tomsic, M. (author)
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- Geirsson, A. J. (author)
- Karolinska Institutet
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Askling, J. (author)
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Glintborg, B. (author)
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- Lindström, Ulf (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research
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(creator_code:org_t)
- 2022-03-22
- 2022
- English.
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In: Rheumatology. - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 61:12, s. 4741-4751
- Related links:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- Objectives Many axial spondylarthritis (axSpA) patients receive a conventional synthetic DMARD (csDMARD) in combination with a TNF inhibitor (TNFi). However, the value of this co-therapy remains unclear. The objectives were to describe the characteristics of axSpA patients initiating a first TNFi as monotherapy compared with co-therapy with csDMARD, to compare one-year TNFi retention and remission rates, and to explore the impact of peripheral arthritis. Methods Data was collected from 13 European registries. One-year outcomes included TNFi retention and hazard ratios (HR) for discontinuation with 95% CIs. Logistic regression was performed with adjusted odds ratios (OR) of achieving remission (Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP < 1.3 and/or BASDAI < 2) and stratified by treatment. Inter-registry heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not significant. Peripheral arthritis was defined as >= 1 swollen joint at baseline (=TNFi start). Results Amongst 24 171 axSpA patients, 32% received csDMARD co-therapy (range across countries: 13.5% to 71.2%). The co-therapy group had more baseline peripheral arthritis and higher CRP than the monotherapy group. One-year TNFi-retention rates (95% CI): 79% (78, 79%) for TNFi monotherapy vs 82% (81, 83%) with co-therapy (P < 0.001). Remission was obtained in 20% on monotherapy and 22% on co-therapy (P < 0.001); adjusted OR of 1.16 (1.07, 1.25). Remission rates at 12 months were similar in patients with/without peripheral arthritis. Conclusion This large European study of axial SpA patients showed similar one-year treatment outcomes for TNFi monotherapy and csDMARD co-therapy, although considerable heterogeneity across countries limited the identification of certain subgroups (e.g. peripheral arthritis) that may benefit from co-therapy.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- spondylitis
- ankylosing
- MTX
- SSZ
- TNF inhibitors
- epidemiology
- modifying antirheumatic drugs
- ankylosing-spondylitis
- rheumatoid-arthritis
- psoriatic-arthritis
- treatment response
- spondyloarthritis
- comedication
- infliximab
- methotrexate
- survival
- Rheumatology
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
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Nissen, M.
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Delcoigne, B.
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Di Giuseppe, D.
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Jacobsson, Lenna ...
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Hetland, M. L.
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Ciurea, A.
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show more...
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Nekvindova, L.
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Iannone, F.
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Akkoc, N.
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Sokka-Isler, T.
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Fagerli, K. M.
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Santos, M. J.
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Codreanu, C.
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Pombo-Suarez, M.
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Rotar, Z.
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Gudbjornsson, B.
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Van der Horst-Br ...
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Loft, A. G.
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Moller, B.
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Mann, H.
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Conti, F.
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Cetin, G. Y.
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Relas, H.
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Michelsen, B.
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Ribeiro, P. A.
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Ionescu, R.
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Sanchez-Piedra, ...
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Tomsic, M.
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Geirsson, A. J.
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Askling, J.
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Glintborg, B.
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Lindström, Ulf
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Rheumatology and ...
- Articles in the publication
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Rheumatology
- By the university
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University of Gothenburg
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Karolinska Institutet