Baseline characteristics of patients starting any TNFi, adalimumab or a newer b/tsDMARD, presented by course of b/tsDMARD treatment
| First course | Any TNFi* | Adalimumab | Abatacept | Apremilast | Ixekizumab | Secukinumab | Tofacitinib | Ustekinumab |
| n | 9269 | 3181 | 26 | 500 | 42 | 266 | 47 | 128 |
| Age, years | 49 (13) | 49 (14) | 57 (12) | 53 (13) | 50 (14) | 50 (14) | 50 (14) | 46 (13) |
| Sex, male, n (%) | 4338 (47) | 1532 (48) | 5 (19) | 234 (47) | 24 (57) | 125 (47) | 17 (36) | 55 (43) |
| Year of start | ||||||||
| 2012–2014 | 2840 (31) | 772 (24) | 8 (31) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 35 (27) |
| 2015–2017 | 2985 (32) | 505 (16) | 6 (23) | 286 (57) | 3 (7) | 125 (47) | 0 (0) | 61 (48) |
| 2018–2020 | 3444 (37) | 1904 (60) | 12 (46) | 214 (43) | 39 (93) | 141 (53) | 47 (100) | 32 (25) |
| Disease duration, years | 5.64 (7.4) | 5.5 (7.5) | 4.3 (5.0) | 6.6 (7.6) | 6.6 (9.1) | 5.9 (7.5) | 6.7 (7.5) | 4.9 (9.7) |
| Number of previous b/tsDMARDs | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Patient pain, mm† | 57 (24) | 56 (24) | 59 (23) | 58 (22) | 31 (27) | 58 (24) | 52 (28) | 48 (26) |
| Patient global health, mm† | 58 (24) | 57 (25) | 58 (24) | 57 (23) | 30 (29) | 58 (24) | 54 (31) | 47 (28) |
| Swollen joint count 28 | 3 (3) | 3 (3) | 3 (5) | 2 (3) | 1 (2) | 3 (4) | 3 (3) | 3 (5) |
| Tender joint count 28 | 5 (5) | 5 (5) | 8 (8) | 5 (6) | 3 (3) | 5 (6) | 5 (4) | 5 (6) |
| CRP, mg/L | 10.4 (17.7) | 9.8 (18.4) | 12.5 (21.0) | 9.4 (16.0) | 4.5 (5.7) | 10.9 (16.3) | 10.1 (10.2) | 11.5 (19.6) |
| DAS28 | 3.95 (1.3) | 3.9 (1.3) | 4.2 (1.6) | 3.9 (1.4) | 2.9 (1.3) | 4.0 (1.4) | 4.0 (1.2) | 3.7 (1.8) |
| DAPSA28 | 25.43 (14.3) | 24.7 (14.0) | 30.9 (20.4) | 24.9 (14.9) | 13.2 (10.1) | 26.5 (18.0) | 26.0 (12.5) | 25.5 (21.7) |
| Previous infection, n (%)‡ | 1900 (21) | 583 (18) | 8 (31) | 129 (26) | 7 (17) | 74 (28) | 9 (19) | 31 (24) |
| Comorbidity score, n (%)§ | ||||||||
| 0 | 8041 (87) | 2829 (90) | 17 (65) | 379 (76) | 36 (86) | 205 (77) | 38 (81) | 112 (88) |
| 1 | 1002 (11) | 293 (9) | 7 (27) | 91 (18) | 4 (10) | 49 (18) | 7 (15) | 13 (10) |
| ≥2 | 226 (2) | 59 (2) | 2 (8) | 30 (6) | 2 (5) | 12 (5) | 2 (4) | 3 (2) |
| Second/third course | ||||||||
| n | 6161 | 2080 | 132 | 272 | 157 | 966 | 185 | 295 |
| Age, years | 50 (13) | 51 (13) | 53 (12) | 54 (12) | 51 (13) | 51 (12) | 54 (13) | 50 (12) |
| Sex, male, n (%) | 2520 (41) | 895 (43) | 53 (40) | 97 (36) | 65 (41) | 406 (42) | 62 (34) | 113 (38) |
| Year of start | ||||||||
| 2012–2014 | 2008 (33) | 565 (27) | 48 (36) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 66 (22) |
| 2015–2017 | 2051 (33) | 450 (22) | 29 (22) | 179 (66) | 4 (3) | 394 (41) | 0 (0) | 159 (54) |
| 2018–2020 | 2102 (34) | 1065 (51) | 55 (42) | 93 (34) | 153 (98) | 572 (59) | 185 (100) | 70 (24) |
| Disease duration, years | 8.48 (8.3) | 8.5 (8.4) | 7.2 (6.7) | 8.8 (8.2) | 8.1 (7.2) | 8.6 (9.0) | 9.4 (10.0) | 8.7 (8.3) |
| Number of previous b/tsDMARDs | 1 (0) | 1 (0) | 2 (0) | 1 (0) | 1 (0) | 2 (1) | 2 (1) | 2 (0) |
| Previous failure of a TNFi due to inefficacy, n (%) | 3059 (50) | 1040 (50) | 69 (52) | 114 (42) | 83 (53) | 588 (61) | 98 (53) | 161 (55) |
| Patient pain, mm† | 58 (25) | 57 (25) | 59 (24) | 64 (23) | 65 (22) | 61 (25) | 62 (22) | 65 (22) |
| Patient global health, mm† | 60 (25) | 58 (26) | 63 (23) | 63 (23) | 71 (22) | 63 (25) | 61 (25) | 67 (23) |
| Swollen joint count 28 | 2 (3) | 2 (3) | 3 (4) | 2 (3) | 3 (3) | 2 (3) | 3 (3) | 2 (3) |
| Tender joint count 28 | 5 (6) | 5 (6) | 7 (6) | 6 (6) | 7 (5) | 5 (6) | 6 (5) | 6 (6) |
| CRP, mg/L | 9.45 (17.8) | 8.9 (15.9) | 12.5 (17.8) | 8.7 (15.7) | 7.3 (9.8) | 8.8 (15.3) | 10.3 (14.0) | 12.8 (21.8) |
| DAS28 | 3.85 (1.3) | 3.8 (1.4) | 4.4 (1.3) | 4.1 (1.3) | 4.3 (1.1) | 3.9 (1.4) | 4.1 (1.4) | 4.0 (1.3) |
| DAPSA28 | 24.94 (15.2) | 24.3 (15.4) | 29.9 (16.8) | 27.6 (13.4) | 29.7 (13.7) | 25.5 (14.9) | 27.3 (14.8) | 26.2 (15.1) |
| Previous infection† | 1607 (26) | 549 (26) | 51 (39) | 96 (35) | 27 (17) | 246 (25) | 52 (28) | 97 (33) |
| Comorbidity score, n (%)§ | ||||||||
| 0 | 5128 (83) | 1708 (82) | 97 (74) | 198 (73) | 130 (83) | 782 (81) | 131 (71) | 232 (79) |
| 1 | 832 (14) | 305 (15) | 29 (22) | 55 (20) | 25 (16) | 139 (14) | 42 (23) | 55 (19) |
| ≥2 | 201 (3) | 67 (3) | 6 (5) | 19 (7) | 2 (1) | 45 (5) | 12 (7) | 8 (3) |
| Fourth course or more | ||||||||
| n | 1546 | 398 | 142 | 177 | 162 | 719 | 274 | 277 |
| Age, years | 51 (12) | 52 (12) | 54 (13) | 53 (10) | 53 (12) | 53 (12) | 53 (12) | 52 (12) |
| Sex, male, n (%) | 567 (37) | 157 (39) | 37 (26) | 64 (36) | 48 (30) | 246 (34) | 84 (31) | 88 (32) |
| Year of start | ||||||||
| 2012–2014 | 417 (27) | 60 (15) | 36 (25) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 69 (25) |
| 2015–2017 | 538 (35) | 111 (28) | 27 (19) | 113 (64) | 3 (2) | 383 (53) | 7 (3) | 128 (46) |
| 2018–2020 | 591 (38) | 227 (57) | 79 (56) | 64 (36) | 159 (98) | 336 (47) | 267 (97) | 80 (29) |
| Disease duration, years | 12.0 (9.6) | 11.3 (9.6) | 11.9 (8.4) | 10.3 (8.4) | 12.7 (8.6) | 12.0 (9.4) | 13.2 (10.0) | 11.0 (9.0) |
| Number of previous b/tsDMARDs | 4 (1) | 4 (1) | 5 (2) | 4 (2) | 5 (2) | 4 (1) | 5 (2) | 4 (1) |
| Previous failure of a TNFi due to inefficacy, n (%) | 1253 (81) | 318 (80) | 103 (73) | 144 (81) | 142 (88) | 605 (84) | 229 (84) | 213 (77) |
| Patient pain, mm† | 65 (24) | 65 (23) | 67 (18) | 65 (23) | 67 (25) | 67 (22) | 69 (22) | 64 (22) |
| Patient global health, mm† | 67 (24) | 68 (23) | 70 (19) | 66 (23) | 69 (25) | 69 (22) | 71 (22) | 66 (23) |
| Swollen joint count 28 | 3 (3) | 3 (4) | 4 (4) | 3 (3) | 3 (3) | 3 (4) | 3 (4) | 3 (4) |
| Tender joint count 28 | 6 (6) | 6 (6) | 8 (6) | 7 (6) | 6 (6) | 6 (6) | 8 (7) | 6 (5) |
| CRP, mg/L | 13.4 (21.9) | 10.8 (14.3) | 17.2 (26.8) | 9.5 (16.1) | 12.3 (21.0) | 14.4 (23.5) | 15.5 (22.6) | 15.1 (22.2) |
| DAS28 | 4.2 (1.3) | 4.2 (1.4) | 4.8 (1.3) | 4.4 (1.2) | 4.3 (1.1) | 4.4 (1.3) | 4.8 (1.3) | 4.5 (1.2) |
| DAPSA28 | 28.4 (15.8) | 27.6 (16.5) | 35.3 (17.1) | 30.9 (15.0) | 30.0 (14.4) | 29.9 (15.6) | 34.4 (17.6) | 29.8 (13.3) |
| Previous infection, n (%)‡ | 495 (32) | 119 (30) | 60 (42) | 77 (44) | 50 (31) | 253 (35) | 119 (43) | 93 (34) |
| Comorbidity score, n (%)§ | ||||||||
| 0 | 1228 (79) | 322 (81) | 103 (73) | 132 (75) | 133 (82) | 555 (77) | 202 (74) | 212 (77) |
| 1 | 263 (17) | 61 (15) | 33 (23) | 30 (17) | 24 (15) | 126 (18) | 52 (19) | 56 (20) |
| ≥2 | 55 (4) | 15 (4) | 6 (4) | 15 (8) | 5 (3) | 38 (5) | 20 (7) | 9 (3) |
Numbers are mean (SD) unless otherwise stated.
*Combined for adalimumab, certolizumab pegol, etanercept, golimumab and infliximab.
†Patient pain and patient global health measures on a 0–100 Visual Analogue Scale.
‡Treated in inpatient or outpatient specialised care 0–5 years before baseline.
§The comorbidity score is the sum of different types of comorbidities for each patient, registered in 0–5 years before baseline; see online supplemental table S1 for definitions. For frequencies of individual comorbidities, see online supplemental table S3.
b/tsDMARDs, biologic and targeted synthetic disease-modifying antirheumatic drugs; CRP, C reactive protein; DAPSA28, Disease Activity index for PSoriatic Arthritis based on 28-joint evaluation; DAS28, Disease Activity Score based on 28-joint evaluation; TNFi, tumour necrosis factor inhibitor.