RT Journal Article
SR Electronic
T1 Uptake and effectiveness of newer biologic and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis: results from five Nordic biologics registries
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 820
OP 828
DO 10.1136/ard-2022-223650
VO 82
IS 6
A1 Bente Glintborg
A1 Daniela Di Giuseppe
A1 Johan Karlsson Wallman
A1 Dan C Nordström
A1 Bjorn Gudbjornsson
A1 Merete Lund Hetland
A1 Johan Askling
A1 Gerdur Grondal
A1 Tuulikki Sokka
A1 Sella A Provan
A1 Brigitte Michelsen
A1 Eirik Klami Kristianslund
A1 Lene Dreyer
A1 Thorvardur Jon Love
A1 Ulf Lindström
YR 2023
UL http://ard.bmj.com/content/82/6/820.abstract
AB Background We aimed to describe the uptake of newer biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in psoriatic arthritis (PsA) in the Nordic countries and to compare their retention and effectiveness.Methods Patients with PsA starting a b/tsDMARD in 2012–2020 in five Nordic rheumatology registers were included. Uptake and patient characteristics were described, with comorbidities identified from linkages to national patient registries. One-year retention and 6-month effectiveness (proportions achieving low disease activity (LDA) on the Disease Activity Index for PSoriatic Arthritis based on 28-joint evaluation) for the newer b/tsDMARDs (abatacept/apremilast/ixekizumab/secukinumab/tofacitinib/ustekinumab) were compared with adalimumab through adjusted regression models stratified by treatment course (first, second/third, and fourth or more).Results In total, 5659 treatment courses with adalimumab (56% biologic-naïve) and 4767 courses with a newer b/tsDMARD (21% biologic-naïve) were included. The uptake of newer b/tsDMARDs increased from 2014 and plateaued in 2018. Patient characteristics appeared similar across treatments at treatment start. Adalimumab was more often used as the first course and newer b/tsDMARDs more often in biologic-experienced patients. Used as a second/third b/tsDMARD, the retention rate and the proportion achieving LDA were significantly better for adalimumab (rate 65%, proportion 59%) compared with abatacept (45%, 37%), apremilast (43%, 35%), ixekizumab (LDA only, 40%) and ustekinumab (LDA only, 40%), but not significantly different from other b/tsDMARDs.Conclusion Uptake of newer b/tsDMARDs occurred mainly in biologic-experienced patients. Regardless of mode of action, only a minority of patients starting a second or later b/tsDMARD course remained on drug and achieved LDA. Superior outcomes for adalimumab indicate that the positioning of newer b/tsDMARDs in the PsA treatment algorithm remains to be established.Due to privacy and ethical concerns any raw data can not be shared. Aggregated data can be shared upon reasonable request