Objectives To determine adverse events and treatment survival of TNF alpha inhibiting treatment in ankylosing spondylitis patients in a large peripheral hospital in daily practice and compare these results with data of other studies (1-3).

Methods A retrospective study design was conducted where data of user characteristics of ankylosing spondylitis patients treated with etanercept, infliximab and adalimumab in the period of January 2004 until January 2014 in the Kennemer Gasthuis were collected. Statistical analyses were performed with Kaplan Meijer survival curves to describe the drug survival and occurrence of adverse events in time.

Results In total 128 ankylosing spondylitis patients were included with 148 treatment episodes (defined as time on drug) over a 10 year time period. The mean treatment duration was 48 months (range 41.4- 54.6 months). Overall, 21% of the patients stopped the TNF alpha inhibitor after a mean period of 15 months, mainly due to inefficacy (53.7%). Only 6 patients stopped because of infections (mild) and no patients had malignancies. Females had a higher change (26%) of developing infections compared to males (19%). Patients using NSAIDs as co-medication developed infections in 41.7% of the 36 cases.

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Conclusions Over a 10 year period nearly 80% of the patients treated with TNF alpha inhibitors continued with an average duration of 48 months per drug.

The most important stop reason was inefficacy. Only 6 patients stopped because of (mild) infections and no malignancies were found. Interestingly, patients using NSAIDs as co-medication developed more often infections than patients without NSAIDs and women developed more often infections than males.

References

1. Glintborg B, Østergaard et al. Ann Rheum Dis 2010.

2. Dreyer L et al. Ann Rheum Dis 2013.

3. Hellgren K et al. Arth & Rheum. 2014.

Disclosure of Interest None declared