Browsing by Author "Ciurea, A"
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Item Predicting ASDAS Inactive Disease After 6 Months of TNFi Treatment in Bio-Naive Axial Spondyloarthritis Patients Treated in Clinical Practice - Results from the EuroSpA CollaborationOrnbjerg, LM; Georgiadis, S; Lindström, U; Loft, AG; Ciurea, A; Mann, H; Akkoç, N; Iannone, F; Kristianslund, E; Hokkanen, AM; Santos, MJ; Codreanu, C; Sánchez-Piedra, C; Tomsic, M; Gudbjornsson, B; van der Horst-Bruinsma, I; Askling, J; Nissen, MJ; Pavelka, K; Gunduz, O; Atzeni, F; Sexton, J; Nordström, D; Santos, H; Ionescu, R; Pombo-Suarez, M; Rotar, Z; Geirsson, AJ; van de Sande, M; Macfarlane, G; Michelsen, B; Hetland, ML; Ostergaard, MItem The impact of a csDMARD in combination with a TNF inhibitor on drug retention and clinical remission in axial spondyloarthritisNissen, M; Delcoigne, B; Di Giuseppe, D; Jacobsson, L; Hetland, ML; Ciurea, A; Nekvindova, L; Iannone, F; Akkoc, N; Sokka-Isler, T; Fagerli, KM; Santos, MJ; Codreanu, C; Pombo-Suarez, M; Rotar, Z; Gudbjornsson, B; Van der Horst-Bruinsma, I; Loft, AG; Möller, B; Mann, H; Conti, F; Cetin, GY; Relas, H; Michelsen, B; Ribeiro, PA; Ionescu, R; Sanchez-Piedra, C; Tomsic, M; Geirsson, AJ; Askling, J; Glintborg, B; Lindström, UObjectives Many axial spondylarthritis (axSpA) patients receive a conventional synthetic DMARD (csDMARD) in combination with a TNF inhibitor (TNFi). However, the value of this co-therapy remains unclear. The objectives were to describe the characteristics of axSpA patients initiating a first TNFi as monotherapy compared with co-therapy with csDMARD, to compare one-year TNFi retention and remission rates, and to explore the impact of peripheral arthritis. Methods Data was collected from 13 European registries. One-year outcomes included TNFi retention and hazard ratios (HR) for discontinuation with 95% CIs. Logistic regression was performed with adjusted odds ratios (OR) of achieving remission (Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP < 1.3 and/or BASDAI < 2) and stratified by treatment. Inter-registry heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not significant. Peripheral arthritis was defined as >= 1 swollen joint at baseline (=TNFi start). Results Amongst 24 171 axSpA patients, 32% received csDMARD co-therapy (range across countries: 13.5% to 71.2%). The co-therapy group had more baseline peripheral arthritis and higher CRP than the monotherapy group. One-year TNFi-retention rates (95% CI): 79% (78, 79%) for TNFi monotherapy vs 82% (81, 83%) with co-therapy (P < 0.001). Remission was obtained in 20% on monotherapy and 22% on co-therapy (P < 0.001); adjusted OR of 1.16 (1.07, 1.25). Remission rates at 12 months were similar in patients with/without peripheral arthritis. Conclusion This large European study of axial SpA patients showed similar one-year treatment outcomes for TNFi monotherapy and csDMARD co-therapy, although considerable heterogeneity across countries limited the identification of certain subgroups (e.g. peripheral arthritis) that may benefit from co-therapy.Item European bio-naive spondyloarthritis patients initiating TNF inhibitor: time trends in baseline characteristics, treatment retention and responseChristiansen, SN; Ornbjerg, LM; Rasmussen, SH; Loft, AG; Askling, J; Iannone, F; Zavada, J; Michelsen, B; Nissen, M; Onen, F; Santos, MJ; Pombo-Suarez, M; Relas, H; Macfarlane, GJ; Tomsic, M; Codreanu, C; Gudbjornsson, B; Van der Horst-Bruinsma, I; Di Giuseppe, D; Glintborg, B; Gremese, E; Pavelka, K; Kristianslund, EK; Ciurea, A; Akkoc, N; Barcelos, A; Sánchez-Piedra, C; Peltomaa, R; Jones, GT; Rotar, Z; Ionescu, R; Grondal, G; Van de Sande, MGH; Laas, K; Ostergaard, M; Hetland, MLObjectives To investigate time trends in baseline characteristics and retention, remission and response rates in bio-naive axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) patients initiating TNF inhibitor (TNFi) treatment. Methods Prospectively collected data on bio-naive axSpA and PsA patients from routine care in 15 European countries were pooled. Three cohorts were defined according to year of TNFi initiation: A (1999-2008), B (2009-2014) and C (2015-2018). Retention, remission and response rates were assessed at 6, 12 and 24 months. Results In total, 27 149 axSpA and 17 446 PsA patients were included. Cohort A patients had longer disease duration compared with B and C. In axSpA, cohort A had the largest proportion of male and HLA-B27 positive patients. In PsA, baseline disease activity was highest in cohort A. Retention rates in axSpA/PsA were highest in cohort A and differed only slightly between B and C. For all cohorts, disease activity decreased markedly from 0 to 6 months. In axSpA, disease activity at 24 months was highest in cohort A, where also remission and response rates were lowest. In PsA, remission rates at 6 and 12 months tended to be lowest in cohort A. Response rates were at all time points comparable across cohorts, and less between-cohort disease activity differences were seen at 24 months. Conclusion Our findings indicate that over the past decades, clinicians have implemented more aggressive treatment strategies in spondyloarthritis. This was illustrated by shorter disease duration at treatment initiation, decreased retention rates and higher remission rates during recent years.Item Predictors of ASDAS-CRP inactive disease in axial spondyloarthritis during treatment with TNF-inhibitors: data from the EuroSpA collaboration (vol 56, 152081, 20222)Ornbjerg, LM; Linde, L; Georgiadis, S; Rasmussen, SH; Lindström, U; Askling, J; Michelsen, B; Di Giuseppe, D; Wallman, JK; Pavelka, K; Závada, J; Nissen, MJ; Jones, GT; Relas, H; Pirilä, L; Tomsic, M; Rotar, Z; Geirsson, AJ; Gudbjornsson, B; Kristianslund, EK; van der Horst-Bruinsma, I; Loft, AG; Laas, K; Iannone, F; Corrado, A; Ciurea, A; Santos, MJ; Santos, H; Codreanu, C; Akkoc, N; Gunduz, OS; Glintborg, B; Ostergaard, M; Hetland, MLItem Predictors of ASDAS-CRP inactive disease in axial spondyloarthritis during treatment with TNF-inhibitors: Data from the EuroSpA collaborationOrnbjerg, LM; Linde, L; Georgiadis, S; Rasmussen, SH; Lindström, U; Askling, J; Michelsen, B; Di Giuseppe, D; Wallman, JK; Pavelka, K; Závada, J; Nissen, MJ; Jones, GT; Relas, H; Pirilä, L; Tomsic, M; Rotar, Z; Geirsson, AJ; Gudbjornsson, B; Kristianslund, EK; Horst-Bruinsma, IV; Loft, AG; Laas, K; Iannone, F; Corrado, A; Ciurea, A; Santos, MJ; Santos, H; Codreanu, C; Akkoc, N; Gunduz, OS; Glintborg, B; Ostergaard, M; Hetland, MLObjectives: In patients with axial spondyloarthritis (axSpA) initiating their first tumor necrosis factor alpha-inhibitor (TNFi), we aimed to identify common baseline predictors of Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP) inactive disease (primary objective) and clinically important improvement (CII) at 6 months, and drug retention at 12-months across 15 European registries. Methods: Baseline demographic and clinical characteristics were collected. Outcomes were investigated per registry and in pooled data using logistic regression analyses on multiply imputed data. Results: The consistency of baseline predictors in individual registries justified pooling the data. In the pooled dataset (n = 21,196), the 6-month rates for ASDAS inactive disease and ASDAS CII were 26% and 51%, and the 12-month drug retention rate 65% in patients with available data (n = 9,845, n = 6,948 and n = 21,196, respectively). Nine common baseline predictors of ASDAS inactive disease, ASDAS CII and 12-month drug retention were identified, and the odds ratios (95%-confidence interval) for ASDAS inactive disease were: age, per year: 0.97 (0.97-0.98), men vs. women: 1.88 (1.60-2.22), current vs. non-smoking: 0.76 (0.63-0.91), HLA-B27 positive vs. negative: 1.51 (1.20-1.91), TNF start year 2015-2018 vs. 2009-2014: 1.24 (1.06-1.45), CRP > 10 vs. <= 10 mg/l: 1.49 (1.25-1.77), one unit increase in health assessment questionnaire (HAQ): 0.77 (0.58-1.03), one-millimeter (mm) increase in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) fatigue and spinal pain: 0.99 (0.99-1.00) and 0.99 (0.99-1.99), respectively Conclusion: Common baseline predictors of treatment response and adherence to TNFi could be identified across data from 15 European registries, indicating that they may be universal across different axSpA populations.Item SECULAR TRENDS IN BASELINE CHARACTERISTICS, TREATMENT RETENTION AND RESPONSE RATES IN 27189 BIO-NAIVE AXIAL SPONDYLOARTHRITIS PATIENTS INITIATING TNFI - RESULTS FROM THE EUROSPA COLLABORATIONOrnbjerg, LM; Christiansen, SN; Rasmussen, SH; Loft, AG; Lindstrom, U; Zavada, J; Iannone, F; Onen, F; Nissen, MJ; Michelsen, B; Santos, MJ; Macfarlane, G; Nordstrom, D; Pombo-Suarez, M; Codreanu, C; Tomsic, M; Van der Horst-Bruinsma, I; Gudbjornsson, B; Askling, J; Glintborg, B; Pavelka, K; Gremese, E; Akkoc, N; Ciurea, A; Kristianslund, E; Barcelos, A; Jones, GT; Hokkanen, AM; Sanchez-Piedra, C; Ionescu, R; Rotar, Z; Van De Sande, MGH; Geirsson, AJ; Ostergaard, M; Hetland, ML