Patient-reported outcomes and PRO remission rates in 12,262 biologic-naïve patients with psoriatic arthritis treated with TNF-inhibitors in routine care

Lykke Midtbøll Ørnbjerg, Kathrine Rugbjerg, Stylianos Georgiadis, Simon Horskjær Rasmussen, Lennart Jacobsson, Anne Gitte Loft, Florenzo Iannone, Karen Minde Fagerli, Jiri Vencovsky, Maria José Santos, Burkhard Möller, Manuel Pombo-Suarez, Ziga Rotar, Björn Guðbjörnsson, Ayse Cefle, Kari Eklund, Catalin Codreanu, Gareth Jones, Marleen van der Sande, Johan Karlsson WallmanMarco Sebastiani, Brigitte Michelsen, Jakub Závada, Michael John Nissen, Carlos Sanchez-Piedra, Matija Tomšič, Þorvarður Jón Löve, Heikki Relas, Corina Mogosan, Merete Lund Hetland, Mikkel Østergaard

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To evaluate patient-reported outcomes (PROs) after initiation of tumor necrosis factor inhibitor (TNFi) treatment in European real-world patients with psoriatic arthritis (PsA). Further, to investigate PRO remission rates across treatment courses, registries, disease duration, sex, and age at disease onset.

METHODS: Visual analog scale or numerical rating scale scores for pain, fatigue, patient global assessment (PtGA), and the Health Assessment Questionnaire-Disability Index (HAQ-DI) from 12,262 patients with PsA initiating a TNFi in 13 registries were pooled. PRO remission rates (pain ≤ 1, fatigue ≤ 2, PtGA ≤ 2, and HAQ-DI ≤ 0.5) were calculated for patients still on the treatment.

RESULTS: For the first TNFi, median pain score was reduced by approximately 50%, from 6 to 3, 3, and 2; as were fatigue scores, from 6 to 4, 4, and 3; PtGA scores, from 6 to 3, 3, and 2; and HAQ-DI scores, from 0.9 to 0.5, 0.5, and 0.4 at baseline, 6, 12, and 24 months, respectively. Six-month Lund Efficacy Index (LUNDEX)-adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 24%, 31%, 36%, and 43% (first TNFi); 14%, 19%, 23%, and 29% (second TNFi); and 9%, 14%, 17%, and 20% (third TNFi), respectively. For biologic-naïve patients with disease duration < 5 years, 6-month LUNDEX-adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 22%, 28%, 33%, and 42%, respectively. Corresponding rates for patients with disease duration > 10 years were 27%, 32%, 41%, and 43%, respectively. Remission rates were 33%, 40%, 45%, and 56% for men and 17%, 23%, 24%, and 32% for women, respectively. For patients aged < 45 years at diagnosis, 6-month LUNDEX-adjusted remission rate for pain was 29% vs 18% for patients ≥ 45 years.

CONCLUSION: In 12,262 biologic-naïve patients with PsA, 6 months of treatment with a TNFi reduced pain by approximately 50%. Marked differences in PRO remission rates across treatment courses, registries, disease duration, sex, and age at onset of disease were observed, emphasizing the potential influence of factors other than disease activity on PROs.

Original languageEnglish
Pages (from-to)378-389
Number of pages12
JournalThe Journal of rheumatology
Volume51
Issue number4
Early online date15 Jan 2024
DOIs
Publication statusPublished - 1 Apr 2024

Bibliographical note

Publisher Copyright:
© 2024 The Journal of Rheumatology.

Other keywords

  • epidemiology
  • fatigue
  • pain
  • psoriatic arthritis
  • tumor necrosis factor inhibitors
  • Humans
  • Male
  • Treatment Outcome
  • Biological Products/therapeutic use
  • Arthritis, Psoriatic/drug therapy
  • Tumor Necrosis Factor Inhibitors/therapeutic use
  • Female
  • Antirheumatic Agents/therapeutic use
  • Pain/drug therapy
  • Patient Reported Outcome Measures

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