Second and third TNF inhibitors in European patients with axial spondyloarthritis: effectiveness and impact of the reason for switching

• Published in: Rheumatology (Oxford, England) England), 2024-07, Vol.63 (7), p.1882-1892
• Main Authors: Linde, Louise, Ørnbjerg, Lykke Midtbøll, Heegaard Brahe, Cecilie, Wallman, Johan Karlsson, Di Giuseppe, Daniela, Závada, Jakub, Castrejon, Isabel, Díaz-Gonzalez, Federico, Rotar, Ziga, Tomšič, Matija, Glintborg, Bente, Gudbjornsson, Bjorn, Geirsson, Arni Jon, Michelsen, Brigitte, Kristianslund, Eirik Klami, Santos, Maria José, Barcelos, Anabela, Nordström, Dan, Eklund, Kari K, Ciurea, Adrian, Nissen, Michael, Akar, Servet, Hejl Hyldstrup, Lise, Krogh, Niels Steen, Hetland, Merete Lund, Østergaard, Mikkel
• Format: Article
• Language: English
• Subjects: Adult; adverse events; Ankylosing spondylitis; Antirheumatic Agents - therapeutic use; Arthritis; axial spondyloarthritis; Axial Spondyloarthritis - drug therapy; C-reactive protein; Clinical Medicine; Clinical Science; Drug Substitution; Drug withdrawal; effectiveness; Europe; Female; Humans; Inflammatory diseases; Klinisk medicin; lack of efficacy; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Prospective Studies; Registries; Remission; Remission (Medicine); Remission Induction; Reumatologi och inflammation; Rheumatic diseases; Rheumatology and Autoimmunity; switching TNF-inhibitors; TNF inhibitors; Treatment Outcome; Tumor Necrosis Factor Inhibitors - therapeutic use; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Tumor necrosis factor-TNF
• ISSN: 1462-0324; 1462-0332; 1462-0332
• DOI: 10.1093/rheumatology/kead494

Abstract Objective To investigate real-world effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with axial spondyloarthritis (axSpA) and the association with (i) treatment line (second and third TNFi-series) and (ii) reason for withdrawal from the preceding TNFi [lack of efficacy (LOE) vs adverse events (AE)]. Methods Prospectively collected routine care data from 12 European registries were pooled. Rates for 12-month drug retention and 6-month remission [Ankylosing Spondylitis Disease Activity Score C-reactive protein inactive disease (ASDAS-ID)] were assessed in second and third TNFi-series and stratified by withdrawal reason. Results We included 8254 s and 2939 third TNFi-series; 12-month drug retention rates were similar (71%). Six-month ASDAS-ID rates were higher for the second (23%) than third TNFi (16%). Twelve-month drug retention rates for patients withdrawing from the preceding TNFi due to AE vs LOE were similar for the second (68% and 67%) and third TNFi (both 68%), while for the second TNFi, rates were lower in primary than secondary non-responders (LOE