For a study, researchers wanted to assess the long-term efficacy and safety of the first anti-tumor necrosis factor (TNFi) medication and to discover the variables related to drug cessation in patients with spondyloarthritis. They reviewed medical records studies. Patients with spondyloarthritis who were prescribed the first TNFi in the Rheumatic Disease Prior Authorization registry between December 2009 and October 2014 were included. Clinical baseline data were obtained. To investigate variables related to medication cessation, the Cox proportional hazards model was utilized.
There were 97 individuals with ankylosing spondylitis (AS) and 41 with psoriatic arthritis among the 138 patients (PsA). The efficacy of TNFi in AS and PsA was 55% to 59% at 4 months and 75% to 96% at 3 years, as determined by a 50% drop in the Bath Ankylosing Spondylitis Disease Activity Index from baseline. At 4 months, 61.8% of patients with PsA with peripheral arthritis had a 50% improvement in the joint count, and 100 percent had a 100% improvement at 3 years. At three years, survival from TNFi was 63% For AS and 56% for PsA. For AS, baseline patient global evaluation of 3 to 6/10 (hazard ratio [HR], 6.3) and usage of leflunomide (HR, 6.0) and infliximab (HR, 6.0) were variables associated with excellent response leading to TNFi cessation (HR, 4.8). The most prevalent reason for cessation of the first TNFi was a positive response (38.5%), followed by toxicity (28.2%), nonadherence (20.5%), and lack of efficacy (12.8% ).
TNFi was effective in treating ankylosing spondylitis and Parkinson’s disease throughout a three-year period. For AS and PsA, the retention rate was roughly 60%. The most prevalent cause for cessation was a positive response to the first TNFi.
Reference:journals.lww.com/jclinrheum/Abstract/2019/01000/Effectiveness_and_Drug_Survival_of_Anti_Tumor.3.aspx
