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  • POS0077 SEX DIFFERENCES IN EFFECTIVENESS OF FIRST-LINE TUMOR NECROSIS FACTOR INHIBITORS IN PSORIATIC ARTHRITIS; RESULTS FROM THIRTEEN COUNTRIES IN THE EuroSpA RESEARCH COLLABORATION NETWORK

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Scientific Abstracts
Poster Tours
New therapeutic avenues in psoriatic arthritis
POS0077 SEX DIFFERENCES IN EFFECTIVENESS OF FIRST-LINE TUMOR NECROSIS FACTOR INHIBITORS IN PSORIATIC ARTHRITIS; RESULTS FROM THIRTEEN COUNTRIES IN THE EuroSpA RESEARCH COLLABORATION NETWORK
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  1. P. Hellamand1,
  2. M. G. H. Van de Sande2,
  3. L. Midtbøll Ørnbjerg3,
  4. T. Klausch4,
  5. N. Trokovic5,
  6. T. Sokka-Isler6,
  7. M. J. Santos7,
  8. E. Vieira-Sousa8,
  9. A. G. Loft9,10,
  10. B. Glintborg11,
  11. M. Østergaard3,12,
  12. U. Lindström13,
  13. J. K. Wallman14,
  14. B. Michelsen3,15,16,
  15. B. Moeller17,
  16. R. Micheroli18,
  17. C. Codreanu19,
  18. C. Mogosan19,
  19. K. Laas20,
  20. Z. Rotar21,22,
  21. K. M. Fagerli23,
  22. M. Tomsic21,22,
  23. I. Castrejon24,
  24. M. Pombo-Suarez25,
  25. B. Gudbjornsson26,
  26. T. Love27,
  27. K. Pavelka28,29,
  28. J. Zavada28,29,
  29. G. Kenar30,
  30. H. Yarkan-Tuğsal30,
  31. M. L. Hetland11,12,
  32. I. Van der Horst-Bruinsma31
  33. on behalf of the EuroSpA Research Collaboration Network
  1. 1Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Clinical Immunology and Rheumatology, Amsterdam, Netherlands
  2. 2Amsterdam University Medical Centers, Academic Medical Center, Department of Clinical Immunology and Rheumatology, Amsterdam, Netherlands
  3. 3Rigshospitalet, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Glostrup, Denmark
  4. 4Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
  5. 5Helsinki University Hospital and Helsinki University, Department of Medicine and Rheumatology, Helsinki, Finland
  6. 6Jyvaskyla Central Hospital, Faculty of Health Sciences, Jyvaskyla, Finland
  7. 7Hospital Garcia de Orta, Serviço de Reumatologia, Almada, Portugal
  8. 8CHULN, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Department of Rheumatology, Lisboa, Portugal
  9. 9Aarhus University Hospital, Department of Rheumatology, Aarhus, Denmark
  10. 10Aarhus University, Department of Clinical Medicine, Aarhus, Denmark
  11. 11Copenhagen University Hospital, Rigshospitalet, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Glostrup, Denmark
  12. 12University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
  13. 13Sahlgrenska Academy at University of Gothenburg, Rheumatology and Inflammation Research, Gothenburg, Sweden
  14. 14Skåne University Hospital, Lund University, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden
  15. 15Diakonhjemmet Hospital, Division of Rheumatology and Research, Oslo, Norway
  16. 16Hospital of Southern Norway Trust, Division of Rheumatology, Department of Medicine, Kristiansand, Norway
  17. 17University Hospital Bern, Inselspital, Bern, Switzerland
  18. 18University Hospital Zurich, Department of Rheumatology, Zurich, Switzerland
  19. 19Center for Rheumatic Diseases, University of Medicine and Pharmacy, Bucharest, Romania
  20. 20East-Tallinn Central Hospital, Department of Rheumatology, Tallinn, Estonia
  21. 21University Medical Centre Ljubljana, Department of Rheumatology, Ljubljana, Slovenia
  22. 22Universitiy of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
  23. 23Diakonhjemmet Hospital, Division of Rheumatology and Research, Oslo, Norway
  24. 24Hospital General Universitario Gregorio Marañón, Department of Rheumatology, Madrid, Spain
  25. 25Hospital Clinico Universitario, Rheumatology Service, Santiago de Compostela, Spain
  26. 26Landspitali, University Hospital, Centre for Rheumatology Research, Reykjavik, Iceland
  27. 27University Hospital, Department of Science, Landspitali, Reykjavik, Iceland
  28. 28Institute of Rheumatology, Department of Rheumatology, Prague, Czech Republic
  29. 29First Faculty of Medicine, Charles University, Department of Rheumatology, Prague, Czech Republic
  30. 30Dokuz Eylul University School of Medicine, Department of Rheumatology, Izmir, Turkey
  31. 31Radboud University Medical Centre, Department of Rheumatology, Nijmegen, Netherlands

Abstract

Background Evidence demonstrates sex differences in disease presentation, physical function, treatment response and drug retention in patients with psoriatic arthritis (PsA). Data from observational cohort studies indicate female sex is associated with reduced effectiveness of tumor necrosis factor inhibitors (TNFis)1,2. Although, conflicting results are also reported3,4. We sought to validate prior studies using data from a large multinational cohort based on real-life clinical practice.

Objectives To investigate sex differences in treatment response and drug retention rates in clinical practice among patients with PsA, treated with their first TNFi.

Methods Data from biologic-naïve PsA patients initiating a TNFi in the EuroSpA registries were pooled. In the primary analysis, propensity-score weighting was applied to assess the causal effect of sex on low disease activity (LDA) according to DAS28-CRP at 6 months. A generalized linear regression model was used to estimate the causal risk difference (RD) and relative risk (RR) of sex on LDA. Possible covariates influencing the outcome were determined a priori and selected based on availability in the database (<20% missing). The final covariates included were country, age, conventional synthetic disease-modifying antirheumatic drug use at baseline and TNFi start year. In the secondary analysis, drug retention was assessed over 24 months of follow-up by Kaplan-Meier curves and log-rank test.

Results In total, 7,679 PsA patients with available data on DAS28-CRP at 6 months were assessed for treatment response. Baseline characteristics are shown in the Table 1. In the adjusted analysis, the probability for females to have LDA was 17% (RR, 0.83; 95% confidence interval [CI], 0.81 to 0.85) lower compared to males and the difference in probability for having LDA was 13 percentage points (RD, 0.13; 95% CI, 0.11 to 0.15). The survival analysis included 18,599 PsA patients with available data on retention rates. The TNFi 6/12/24-month retention rates were significantly lower in females (81%/68%/56%) compared to males (89%/80%/69%), see Figure 1.

View this table:
Table 1.

Baseline characteristics of all biologic-naïve PsA patients treated with their first TNFi and available DAS28-CRP at 6 month, data pooled across all countries

Conclusion Treatment efficacy and retention rates are lower among female patients with PsA initiating their first TNFi. Females presented with higher 28-tender joint count and higher scores on patient reported outcomes at baseline, reflecting differences in disease expression. Recognizing these sex differences is of relevance for customized patient care and may improve patient education.

References [1]Højgaard, et al. Rheumatology (Oxford). 2018 Sep 1;57(9):1651-1660.

[2]Vieira-Sousa, et al. J Rheumatol. 2020 May 1;47(5):690-700.

[3]Kristensen, et al. Ann Rheum. Dis. 2008 Mar;67(3):364-9.

[4]Iervolino, et al. J Rheumatol. 2012 Mar;39(3):568-73.

Figure

Acknowledgements Novartis Pharma AG and IQVIA for supporting the EuroSpA collaboration.

Disclosure of Interests Pasoon Hellamand Grant/research support from: Novartis, Marleen G.H. van de Sande Speakers bureau: UCB, Consultant of: Abbvie, Eli Lily, Novartis, UCB, Grant/research support from: Novartis, Janssen, UCB and Eli Lilly, Lykke Midtbøll Ørnbjerg Grant/research support from: Novartis, Thomas Klausch: None declared, Nina Trokovic: None declared, Tuulikki Sokka-Isler Consultant of: Abbvie, Amgen, BMS, Celgene, DiaGraphIT, Medac, MSD, Novartis, Orionpharma, Pfizer, Roche, Sandoz, and UCB, Maria Jose Santos Speakers bureau: Abbvie, AstraZeneca, Lilly, Novartis and Pfizer, Elsa Vieira-Sousa Speakers bureau: MSD, Celgene, Novartis, Janssen, Abbvie and Pfizer, Consultant of: MSD, Celgene, Novartis, Janssen, Abbvie and Pfizer, Grant/research support from: MSD, Celgene, Novartis, Janssen, Abbvie and Pfizer, Anne Gitte Loft Speakers bureau: AbbVie, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Consultant of: AbbVie, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Grant/research support from: Novartis, Bente Glintborg Grant/research support from: Pfizer, Abbvie, BMS, Mikkel Østergaard Speakers bureau: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi and UCB, Consultant of: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi and UCB, Grant/research support from: Abbvie, BMS, Merck, Celgene, Novartis, Ulf Lindström: None declared, Johan K Wallman Consultant of: AbbVie, Amgen, Celgene, Eli Lilly and Novartis, Brigitte Michelsen Grant/research support from: Novartis, Burkhard Moeller Speakers bureau: MSD, Synergy, Eli Lilly, Bristol-Myers-Squibb, Janssen-Cilag, AbbVie and Pfizer, Raphael Micheroli: None declared, Catalin Codreanu Speakers bureau: AbbVie, Amgen, Boehringer Ingelheim, Ewopharma, Lilly, Novartis and Pfizer, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Ewopharma, Lilly, Novartis and Pfizer, Corina Mogosan Speakers bureau: AbbVie, Ewopharma, Lilly, Novartis and Pfizer, Consultant of: AbbVie, Ewopharma, Lilly, Novartis and Pfizer, Karin Laas Speakers bureau: Amgen, Janssen, Novartis and Abbvie, Ziga Rotar Speakers bureau: Abbvie, Novartis, MSD, Medis, Biogen, Eli Lilly, Pfizer, Sanofi, Lek and Janssen, Consultant of: Abbvie, Novartis, MSD, Medis, Biogen, Eli Lilly, Pfizer, Sanofi, Lek and Janssen, Karen Minde Fagerli: None declared, Matija Tomsic Speakers bureau: Abbvie, Amgen, Biogen, Eli Lilly, Janssen, Medis, MSD, Novartis, Pfizer, Sanofi, Sandoz-Lek, Consultant of: Abbvie, Amgen, Biogen, Eli Lilly, Janssen, Medis, MSD, Novartis, Pfizer, Sanofi, Sandoz-Lek, Isabel Castrejon Speakers bureau: Lilly, BMS, Janssen, MSD and Abbvie, Consultant of: Lilly, BMS, Janssen, MSD and Abbvie, Manuel Pombo-Suarez Consultant of: Abbvie, MSD and Roche, Björn Gudbjornsson Speakers bureau: Amgen and Novartis, Consultant of: Amgen and Novartis, Thorvardur Love: None declared, Karel Pavelka Speakers bureau: Pfizer, MSD, BMS, UCB, Amgen, Egis, Roche and AbbVie, Consultant of: Pfizer, MSD, BMS, UCB, Amgen, Egis, Roche and AbbVie, Jakub Zavada Speakers bureau: Abbvie, Elli-Lilly, Sandoz, Novartis, Egis and UCB, Consultant of: Abbvie, Elli-Lilly, Sandoz, Novartis, Egis and UCB, Gökçe Kenar: None declared, Handan Yarkan-Tuğsal: None declared, Merete Lund Hetland Grant/research support from: Abbvie, Biogen, BMS, Celltrion, Eli Lilly, Janssen Biologics B.V, Lundbeck Fonden, MSD, Medac, Pfizer, Roche, Samsung Biopies, Sandoz and Novartis, Irene van der Horst-Bruinsma Speakers bureau: BMS, AbbVie, Pfizer and MSD, Consultant of: Abbvie, UCB, MSD, Novartis and Lilly, Grant/research support from: MSD, Pfizer, AbbVie and UCB

http://dx.doi.org/10.1136/annrheumdis-2022-eular.1699

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