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01-09-2020 | Etanercept | Original Article

Retention rates and identification of factors associated with anti-TNFα, anti-IL17, and anti-IL12/23R agents discontinuation in psoriatic arthritis patients: results from a real-world clinical setting

Authors: Luca Navarini, Luisa Costa, Marco Tasso, Maria Sole Chimenti, Damiano Currado, Giulia Lavinia Fonti, Massimo Ciccozzi, Domenico Paolo Emanuele Margiotta, Carolina Benigno, Erica De Martino, Roberto Perricone, Antonella Afeltra, Raffaele Scarpa, Francesco Caso

Published in: Clinical Rheumatology | Issue 9/2020

Abstract

Introduction

Biologic disease-modifying antirheumatic drugs (bDMARDs) play a pivotal role in the treatment of psoriatic arthritis (PsA). Despite this, their discontinuation due to inefficacy or adverse events is often observed. The aims of this study are to describe retention rates and treatment trends of anti-TNFα, anti-IL17, and anti-IL12/23R agents in patients with PsA and to identify factors associated with bDMARDs discontinuation in a real-world clinical setting.

Methods

A retrospective cohort study based on the analysis of the three Italian prescription cohorts of patients with PsA has been performed. Survival analysis was performed using Kaplan-Meier curves and Cox proportional-hazards model.

Results

During the follow up, which lasted 25.5 (12–60) months, 68 patients discontinued a bDMARD: 13 for primary failure, 12 for secondary failure, 15 for adverse events, 5 for remission, 12 because of lost at follow-up, and 11 for other causes. Cox proportional-hazards demonstrated that a shorter disease duration (HR 0.994991, 95% CI 0.9910336–0.9989647, p = 0.014) and first-line bDMARD (HR 0.5090986, 95% CI 0.3073519–0.8432722, p = 0.009) have a protective role on bDMARD retention rate, while the multivariable analysis failed in demonstrating an independent protective role of male sex on drug retention rate (p = 0.083). No significant differences in retention rate have been found regarding biologic drugs, combination therapy or monotherapy, and class of bDMARD (anti-TNFα or anti-pIL12/23R and anti-IL-17).

Conclusions

This study shows that a shorter disease duration and treatment with a first-line bDMARD are predictors of bDMARDs retention rate, further highlighting the importance of early diagnosis of PsA.

Key Points

• No significant difference in retention among patients treated with anti-IL17A, anti-IL12/23R, and anti-TNFα agents has been demonstrated.

• A shorter disease duration and first-line bDMARD treatment are associated with persistence in biologic treatment.

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Marchesoni A, Olivieri I, Salvarani C, Pipitone N, D'Angelo S, Mathieu A, Cauli A, Punzi L, Ramonda R, Scarpa R, Maccarone M, Lubrano E (2017) Recommendations for the use of biologics and other novel drugs in the treatment of psoriatic arthritis: 2017 update from the Italian Society of Rheumatology. Clin Exp Rheumatol 35(6):991–1010PubMed

Napolitano M, Caso F, Scarpa R, Megna M, Patri A, Balato N, Costa L (2016) Psoriatic arthritis and psoriasis: differential diagnosis. Clin Rheumatol 35(8):1893–1901. https://doi.org/10.1007/s10067-016-3295-9CrossRefPubMed

Caso F, Costa L, Atteno M, Del Puente A, Cantarini L, Lubrano E, Scarpa R (2014) Simple clinical indicators for early psoriatic arthritis detection. SpringerPlus 3:759. https://doi.org/10.1186/2193-1801-3-759CrossRefPubMedPubMedCentral

Caso F, Costa L, Del Puente A, Di Minno MN, Lupoli G, Scarpa R, Peluso R (2015) Pharmacological treatment of spondyloarthritis: exploring the effectiveness of nonsteroidal anti-inflammatory drugs, traditional disease-modifying antirheumatic drugs and biological therapies. Ther Adv Chronic Dis 6(6):328–338. https://doi.org/10.1177/2040622315608647CrossRefPubMedPubMedCentral

Megna M, Balato A, Napolitano M, Gallo L, Caso F, Costa L, Balato N, Scarpa R (2018) Psoriatic disease treatment nowadays: unmet needs among the “jungle of biologic drugs and small molecules”. Clin Rheumatol 37(7):1739–1741. https://doi.org/10.1007/s10067-018-4090-6CrossRefPubMed

Caso F, Lubrano E, Del Puente A, Caso P, Peluso R, Foglia F, Benigno C, Girolimetto N, Bottiglieri P, Scarpa R, Costa L (2016) Progress in understanding and utilizing TNF-α inhibition for the treatment of psoriatic arthritis. Expert Rev Clin Immunol 12(3):315–331. https://doi.org/10.1586/1744666x.2016.1117941CrossRefPubMed

Caso F, Costa L, Del Puente A, Scarpa R (2015) Psoriatic arthritis and TNF inhibitors: advances on effectiveness and toxicity. Expert Opin Biol Ther 15(1):1–2. https://doi.org/10.1517/14712598.2015.973398CrossRefPubMed

Caso F, Del Puente A, Peluso R, Caso P, Girolimetto N, Del Puente A, Scarpa R, Costa L (2016) Emerging drugs for psoriatic arthritis. Exp Opin Emerg Drugs 21(1):69–79. https://doi.org/10.1517/14728214.2016.1146679CrossRef

Atzeni F, Costa L, Caso F, Scarpa R, Sarzi-Puttini P (2015) Role of agents other than tumor necrosis factor blockers in the treatment of psoriatic arthritis. J Rheumatol Suppl 93:79–81. https://doi.org/10.3899/jrheum.150643CrossRefPubMed

10.

Scarpa R, Costa L, Atteno M, Del Puente A, Caso F, Moll JM (2013) Psoriatic arthritis: advances in pharmacotherapy based on molecular target. Expert Opin Pharmacother 14(17):2311–2313. https://doi.org/10.1517/14656566.2013.840292CrossRefPubMed

11.

Costa L, Del Puente A, Peluso R, Tasso M, Caso P, Chimenti MS, Sabbatino V, Girolimetto N, Benigno C, Bertolini N, Del Puente A, Perricone R, Scarpa R, Caso F (2017) Small molecule therapy for managing moderate to severe psoriatic arthritis. Expert Opin Pharmacother 18(15):1557–1567. https://doi.org/10.1080/14656566.2017.1378343CrossRefPubMed

12.

Chiricozzi A, Saraceno R, Novelli L, Fida M, Caso F, Scarpa R, Costa L, Perricone R, Romanelli M, Chimenti S, Chimenti MS (2016) Small molecules and antibodies for the treatment of psoriasis: a patent review (2010-2015). Exp Opin Ther Pat 26(7):757–766. https://doi.org/10.1080/13543776.2016.1192129CrossRef

13.

Coates LC, Kavanaugh A, Mease PJ, Soriano ER, Laura Acosta-Felquer M, Armstrong AW, Bautista-Molano W, Boehncke WH, Campbell W, Cauli A, Espinoza LR, FitzGerald O, Gladman DD, Gottlieb A, Helliwell PS, Husni ME, Love TJ, Lubrano E, McHugh N, Nash P, Ogdie A, Orbai AM, Parkinson A, O'Sullivan D, Rosen CF, Schwartzman S, Siegel EL, Toloza S, Tuong W, Ritchlin CT (2016) Group for research and assessment of psoriasis and psoriatic arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol (Hoboken, NJ) 68(5):1060–1071. https://doi.org/10.1002/art.39573CrossRef

14.

Gossec L, Coates LC, de Wit M, Kavanaugh A, Ramiro S, Mease PJ, Ritchlin CT, van der Heijde D, Smolen JS (2016) Management of psoriatic arthritis in 2016: a comparison of EULAR and GRAPPA recommendations. Nat Rev Rheumatol 12(12):743–750. https://doi.org/10.1038/nrrheum.2016.183CrossRefPubMed

15.

Gossec L, Smolen JS, Ramiro S, de Wit M, Cutolo M, Dougados M, Emery P, Landewe R, Oliver S, Aletaha D, Betteridge N, Braun J, Burmester G, Canete JD, Damjanov N, FitzGerald O, Haglund E, Helliwell P, Kvien TK, Lories R, Luger T, Maccarone M, Marzo-Ortega H, McGonagle D, McInnes IB, Olivieri I, Pavelka K, Schett G, Sieper J, van den Bosch F, Veale DJ, Wollenhaupt J, Zink A, van der Heijde D (2016) European league against rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Ann Rheum Dis 75(3):499–510. https://doi.org/10.1136/annrheumdis-2015-208337CrossRefPubMed

16.

Costa L, Lubrano E, Ramonda R, Chimenti MS, Vezzu M, Perrotta FM, Del Puente A, Peluso R, Bottiglieri P, Lorenzin M, Sunzini F, Darda MA, Fiocco U, Perricone R, Punzi L, Scarpa R, Caso F (2017) Elderly psoriatic arthritis patients on TNF-α blockers: results of an Italian multicenter study on minimal disease activity and drug discontinuation rate. Clin Rheumatol 36(8):1797–1802. https://doi.org/10.1007/s10067-017-3697-3CrossRefPubMed

17.

Caso F, Cantarini L, Morisco F, Del Puente A, Ramonda R, Fiocco U, Lubrano E, Peluso R, Caso P, Galeazzi M, Punzi L, Scarpa R, Costa L (2015) Current evidence in the field of the management with TNF-α inhibitors in psoriatic arthritis and concomitant hepatitis C virus infection. Expert Opin Biol Ther 15(5):641–650. https://doi.org/10.1517/14712598.2015.1011616CrossRefPubMed

18.

Costa L, Caso F, Del Puente A, Di Minno MN, Peluso R, Scarpa R (2016) Incidence of malignancies in a cohort of psoriatic arthritis patients taking traditional disease modifying antirheumatic drug and tumor necrosis factor inhibitor therapy: an observational study. J Rheumatol 43(12):2149–2154. https://doi.org/10.3899/jrheum.160542CrossRefPubMed

19.

Atteno M, Costa L, Matarese A, Caso F, Del Puente A, Cantarini L, Bocchino ML, Sanduzzi A, Scarpa R (2014) The use of TNF-α blockers in psoriatic arthritis patients with latent tuberculosis infection. Clin Rheumatol 33(4):543–547. https://doi.org/10.1007/s10067-014-2536-zCrossRefPubMedPubMedCentral

20.

Napolitano M, Costa L, Caso F, Megna M, Scarpa R, Balato N, Ayala F, Balato A (2017) Minimal disease activity in patients with psoriatic arthritis treated with ustekinumab: results from a 24-week real-world study. Clin Rheumatol 36(7):1589–1593. https://doi.org/10.1007/s10067-017-3700-zCrossRefPubMed

21.

Chimenti MS, Ortolan A, Lorenzin M, Triggianese P, Talamonti M, Costa L, Caso F, Favero M, Teoli M, Galluzzo M, Scarpa R, Punzi L, Perricone R, Ramonda R (2018) Effectiveness and safety of ustekinumab in naive or TNF-inhibitors failure psoriatic arthritis patients: a 24-month prospective multicentric study. Clin Rheumatol 37(2):397–405. https://doi.org/10.1007/s10067-017-3953-6CrossRefPubMed

22.

Costa L, Perricone C, Chimenti MS, Del Puente A, Caso P, Peluso R, Bottiglieri P, Scarpa R, Caso F (2017) Switching between biological treatments in psoriatic arthritis: a review of the evidence. Drugs R&D 17(4):509–522. https://doi.org/10.1007/s40268-017-0215-7CrossRef

23.

Murage MJ, Tongbram V, Feldman SR, Malatestinic WN, Larmore CJ, Muram TM, Burge RT, Bay C, Johnson N, Clifford S, Araujo AB (2018) Medication adherence and persistence in patients with rheumatoid arthritis, psoriasis, and psoriatic arthritis: a systematic literature review. Patient Prefer Adherence 12:1483–1503. https://doi.org/10.2147/PPA.S167508CrossRefPubMedPubMedCentral

24.

Mease PJ, Collier DH, Saunders KC, Li G, Kremer JM, Greenberg JD (2015) Comparative effectiveness of biologic monotherapy versus combination therapy for patients with psoriatic arthritis: results from the Corrona registry. RMD open 1(1):e000181–e000181. https://doi.org/10.1136/rmdopen-2015-000181CrossRefPubMedPubMedCentral

25.

Salvarani C, Pipitone N, Marchesoni A, Cantini F, Cauli A, Lubrano E, Punzi L, Scarpa R, Spadaro A, Matucci-Cerinic M, Olivieri I (2011) Recommendations for the use of biologic therapy in the treatment of psoriatic arthritis: update from the Italian Society for Rheumatology. Clin Exp Rheumatol 29(3 Suppl 66):S28–S41PubMed

26.

Coates LC, Fransen J, Helliwell PS (2010) Defining minimal disease activity in psoriatic arthritis: a proposed objective target for treatment. Ann Rheum Dis 69(1):48–53. https://doi.org/10.1136/ard.2008.102053CrossRefPubMed

27.

Hernandez MV, Sanchez-Piedra C, Garcia-Magallon B, Cuende E, Manero J, Campos-Fernandez C, Martin-Domenech R, Del Pino-Montes J, Manrique S, Castro-Villegas MC, Ruiz-Montesinos D, Sanchez-Alonso F, Diaz-Gonzalez F, Cea-Calvo L, Gomez-Reino JJ (2019) Factors associated with long-term retention of treatment with golimumab in a real-world setting: an analysis of the Spanish BIOBADASER registry. Rheumatol Int 39(3):509–515. https://doi.org/10.1007/s00296-018-4177-zCrossRefPubMed

28.

Favalli EG, Pontikaki I, Becciolini A, Biggioggero M, Ughi N, Romano M, Crotti C, Gattinara M, Gerloni V, Marchesoni A, Meroni PL (2017) Real-life 10-year retention rate of first-line anti-TNF drugs for inflammatory arthritides in adult- and juvenile-onset populations: similarities and differences. Clin Rheumatol 36(8):1747–1755. https://doi.org/10.1007/s10067-017-3712-8CrossRefPubMed

29.

Fabbroni M, Cantarini L, Caso F, Costa L, Pagano VA, Frediani B, Manganelli S, Galeazzi M (2014) Drug retention rates and treatment discontinuation among anti-TNF-α agents in psoriatic arthritis and ankylosing spondylitis in clinical practice. Mediat Inflamm 2014:862969. https://doi.org/10.1155/2014/862969CrossRef

30.

Favalli EG, Selmi C, Becciolini A, Biggioggero M, Ariani A, Santilli D, Fusaro E, Parisi S, Massarotti M, Marchesoni A, Meroni PL (2017) Eight-year retention rate of first-line tumor necrosis factor inhibitors in spondyloarthritis: a multicenter retrospective analysis. Arthritis Care Res (Hoboken) 69(6):867–874. https://doi.org/10.1002/acr.23090CrossRef

Title: Retention rates and identification of factors associated with anti-TNFα, anti-IL17, and anti-IL12/23R agents discontinuation in psoriatic arthritis patients: results from a real-world clinical setting
Authors: Luca Navarini
Luisa Costa
Marco Tasso
Maria Sole Chimenti
Damiano Currado
Giulia Lavinia Fonti
Massimo Ciccozzi
Domenico Paolo Emanuele Margiotta
Carolina Benigno
Erica De Martino
Roberto Perricone
Antonella Afeltra
Raffaele Scarpa
Francesco Caso
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keywords: Etanercept
Certolizumab
Ustekinumab
Psoriatic Arthritis
Secukinumab
Golimumab
Published in: Clinical Rheumatology / Issue 9/2020
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-020-05027-1

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