Friday, 21 Sep 2018

You are here

Ankylosing Spondylitis Women Show Less Durable Responses to TNF Inhibitors

A study from the Netherlands has shown that the long-term drug survival of TNF inhibitors differ between men and women, with women having a lower long-term retention rate compared to men.  (Citation source: http://bit.ly/2KZQ0DJ)

A single-center, retrospective study of 122 anklylosing spondylitis (AS) patients, analyzed the outcomes of those receiving either  etanercept, adalimumab, or infliximab between 2004 and 2014.

Nearly 40% were women and most AS patients received adalimumab (59.7%), compared to etanercept (28.9%) or infliximab (11.3%).

This 10-year analysis (mean follow-up duration was 5.1 years) showed several interesting results:

  • the best TNFi survival rate with etanercept (85.3% after 3.7 years), followed by adalimumab and infliximab.
  • 17.2% eventually stopped TNFi without starting a new therapy,
  • 26.2% stopped their TNFi and then switched to another anti-TNF agent.
  • TNFi discontinuation were due to inefficacy (52.4%), vollowed by adverse events, especially infections.
  • Women had significantly lower treatment survival than men (women 33.4 mos versus men 44.9 mos (P = .031)
  • Women switched to another drugy more frequently than men (26.9% vs 16.3%)
  • Women were more likely to completely stop anti-TNF therapy (vs. men) (20.8% vs 14.9%, not significant).

 Factors that drive these differences will require further study. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Biologic Therapies Improve Work Outcomes in Spondyloarthritis

A study from the British Society for Rheumatology Biologics Register in Axial Spondyloarthritis (BSRBR-AS) shows that biologic use significantly improves work productivity and overall activity impairment.

 

The BSRBR-AS registry analyzed 577 participants who were employed;  28% were started on biological therapy .

BMS Tyk 2 Inhibitor Benefits Psoriasis

The NEJM reports that an oral selecive Tyrosine kinase 2 (TYK2) inhibitor of TYK2 was shown to be superior to placebo in a 12 week trial in patients with active psoriasis.

Methotrexate's Low Efficacy in Cutaneous Psoriasis

In a prospective, double-blind, randomized placebo-controlled study, Warren et al. studied the effect of an intensified methotrexate (MTX) in chronic plaque psoriasis and showed MTX to be effective and superior to placebo.

No Cancer Risk from Psoriatic Arthritis

Inflammmation is a strong risk factor for malignancy. Yet there are mixed results on whether patients with psoriatic arthritis (PsAg) augments the incidence of cancer and all-cause and cause-mortality.

A study from the national British Society for Rheumatology Biologics Register examined the risk of cancer, assessed by standardized incidence ratios (SIRs)  or standardized mortality ratios (SMRs).

Treatments Do Not Increase Infection Risk in Ankylosing Spondylitis

A large Canadian study of the drug use in ankylosing spondylitis (AS) demonstrated no evidence that the risk of serious,  hospitalized infection was influenced by the use of DMARD and/or of tumour necrosis factor inhibitors (TNFi) therapy.

They studied 747 AS patients who initiated TNFI and/or DMARDs between 2001 and 2011 to identify hospitalized infection  coding data and hospital discharge diagnoses.