Browsing by Author "Mann, H"

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    The impact of a csDMARD in combination with a TNF inhibitor on drug retention and clinical remission in axial spondyloarthritis
    (OXFORD UNIV PRESS) Nissen, 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, U
    Objectives 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.
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    Predicting ASDAS Inactive Disease After 6 Months of TNFi Treatment in Bio-Naive Axial Spondyloarthritis Patients Treated in Clinical Practice - Results from the EuroSpA Collaboration
    (WILEY) Ornbjerg, 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, M