Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis:Comparison of Tumor Necrosis Factor Inhibitor Effectiveness and Effect of HLA-B27 Status. An Observational Cohort Study from the Nationwide DANBIO Registry
| Autor: | B. Glintborg, Abdiweli Awil Mohamoud, Mikkel Østergaard, D. G. A. Kraus, Laura Danielsen, Johnny Lillelund Raun, Niels Steen Krogh, Marcin Ryszard Kowalski, Inger Marie Jensen Hansen, Jens Kristian Pedersen, Lene Dreyer, Oliver Hendricks, Henrik Nordin, Anne Gitte Loft, R. Pelck, Jakob Esbesen, Nabil Al Chaer, Inge Juul Sørensen, Merete Lund Hetland, Annette Schlemmer, S. R. Christensen, Lone Salomonsen, Lis Smedegaard Andersen |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Immunology Observational Study Logistic regression Severity of Illness Index Medication Adherence Cohort Studies 03 medical and health sciences 0302 clinical medicine Rheumatology Internal medicine Spondylarthritis medicine Journal Article Immunology and Allergy Humans Spondylitis Ankylosing 030212 general & internal medicine Registries BASDAI HLA-B27 Antigen 030203 arthritis & rheumatology Ankylosing spondylitis HLA-B27 Biological Products business.industry Tumor Necrosis Factor-alpha Confounding Sacroiliac Joint Middle Aged medicine.disease Surgery Treatment Outcome Antirheumatic Agents Cohort Tumor necrosis factor alpha Female business Cohort study |
| Zdroj: | Glintborg, B, Sørensen, I J, Østergaard, M, Dreyer, L, Mohamoud, A A, Krogh, N S, Hendricks, O, Andersen, L S, Raun, J L, Kowalski, M R, Danielsen, L, Pelck, R, Nordin, H, Pedersen, J K, Kraus, D, Christensen, S R, Hansen, I M, Esbesen, J, Schlemmer, A, Loft, A G, Al Chaer, N, Salomonsen, L & Hetland, M L 2017, ' Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis : Comparison of Tumor Necrosis Factor Inhibitor Effectiveness and Effect of HLA-B27 Status. An Observational Cohort Study from the Nationwide DANBIO Registry ', Journal of Rheumatology, vol. 44, no. 1, pp. 59-69 . https://doi.org/10.3899/jrheum.160958 Glintborg, B, Sørensen, I J, Østergaard, M, Dreyer, L, Mohamoud, A A, Krogh, N S, Hendricks, O, Andersen, L S, Raun, J L, Kowalski, M R, Danielsen, L, Pelck, R, Nordin, H, Pedersen, J K, Kraus, D G A, Christensen, S R, Hansen, I M J, Esbesen, J, Schlemmer, A, Loft, A G, Al Chaer, N, Salomonsen, L & Hetland, M L 2017, ' Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis : Comparison of Tumor Necrosis Factor Inhibitor Effectiveness and Effect of HLA-B27 Status. An Observational Cohort Study from the Nationwide DANBIO Registry ', Journal of Rheumatology, vol. 44, no. 1, pp. 59-69 . https://doi.org/10.3899/jrheum.160958 Glintborg, B, Sørensen, I J, Østergaard, M, Dreyer, L, Mohamoud, A A, Krogh, N S, Hendricks, O, Andersen, L S, Raun, J L, Kowalski, M R, Danielsen, L, Pelck, R, Nordin, H, Pedersen, J K, Kraus, D G A, Christensen, S R, Jensen Hansen, I M, Esbesen, J, Schlemmer, A, Loft, A G, Al Chaer, N, Salomonsen, L & Hetland, M L 2017, ' Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis : Comparison of Tumor Necrosis Factor Inhibitor Effectiveness and Effect of HLA-B27 Status. An Observational Cohort Study from the Nationwide DANBIO Registry ', Journal of Rheumatology, vol. 44, no. 1, pp. 59-69 . https://doi.org/10.3899/jrheum.160958 |
| DOI: | 10.3899/jrheum.160958 |
| Popis: | Objective.To compare baseline disease activity and treatment effectiveness in biologic-naive patients with nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) who initiate tumor necrosis factor inhibitor (TNFi) treatment and to study the role of potential confounders (e.g., HLA-B27 status).Methods.Observational cohort study based on prospectively registered data in the nationwide DANBIO registry. We used Kaplan-Meier plots, Cox, and logistic regression analyses to study the effect of diagnosis (nr-axSpA vs AS) and potential confounders (sex/age/start yr/HLA-B27/disease duration/TNFi-type/smoking/baseline disease activity) on TNFi adherence and response [e.g., Bath Ankylosing Spondylitis Activity Index (BASDAI) 50%/20 mm].Results.The study included 1250 TNFi-naive patients with axSpA (29% nr-axSpA, 50% AS, 21% lacked radiographs of sacroiliac joints). Patients with nr-axSpA were more frequently women (50%/27%) and HLA-B27–negative (85/338 = 25%), compared to AS (81/476 = 17%; p < 0.01). At TNFi start patients with nr-axSpA had higher visual analog scale scores [median (quartiles)] for pain: 72 mm (55–84)/65 mm (48–77); global: 76 mm (62–88)/68 mm (50–80); fatigue: 74 mm (55–85)/67 mm (50–80); and BASDAI: 64 (54–77)/59 (46–71); all p < 0.01. However, patients with nr-axSpA had lower C-reactive protein: 7 mg/l (3–17)/11 mg/l (5–22); and BAS Metrology Index: 20 (10–40)/40 (20–50); all p < 0.01. Median (95% CI) treatment adherence was poorer in nr-axSpA than in AS: 1.59 years (1.15–2.02) versus 3.67 years (2.86–4.49), p < 0.0001; but only in univariate and not confounder-adjusted analyses (p > 0.05). Response rates were similar in AS and nr-axSpA (p > 0.05). HLA-B27 negativity was associated with poorer treatment adherence [HLA-B27 negative/positive, nr-axSpA: HR 1.74 (1.29–2.36), AS: HR 2.04 (1.53–2.71), both p < 0.0001]; and lower response rates (nr-axSpA: 18/61 = 30% vs 93/168 = 55%; AS: 17/59 = 29% vs 157/291 = 54%, both p < 0.05).Conclusion.In this nationwide cohort, patients with nr-axSpA had higher subjective disease activity at start of first TNFi treatment, but similar outcomes to patients with AS after confounder adjustment. HLA-B27 positivity was associated with better outcomes irrespective of axSpA subdiagnosis. |
| Databáze: | OpenAIRE |
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