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CHICAGO – Adding disease-modifying antirheumatic drugs to anti-TNF therapy failed to enhance drug retention in a study involving 1,630 adults with spondyloarthritis.
Current ankylosing spondylitis recommendations from the Assessment of SpondyloArthritis international Society (ASAS) and the European League Against Rheumatism do not support adding disease-modifying antirheumatic drugs (DMARDs) to anti-TNF therapy, said Dr. Michael Nissen of University Hospital Geneva (Switzerland).
Yet, in practice, cotherapy often is prescribed, and the impact of this addition has not been well studied, he said at the annual meeting of the American College of Rheumatology.
"Utilization of a DMARD with an anti-TNF agent is of no additional benefit in SpA [spondyloarthritis] patients in terms of drug survival," and the study findings support the current treatment recommendations, he added.
Dr. Nissen and his colleagues reviewed data from patient registries that included 1,060 adults with axial spondyloarthritis, 535 with psoriatic arthritis, and 35 with undifferentiated spondyloarthritis.
A total of 1,123 patients (69%) had anti-TNF monotherapy and 507 (31%) had DMARD/anti-TNF cotherapy. Among the cotherapy patients, 72% received methotrexate, 21% received sulfasalazine, and 14% received leflunomide. The mean ages in the monotherapy and cotherapy groups were 43 years and 46 years, respectively, and slightly more than half of patients in each group were male.
After a median follow-up period of 4 years, overall drug retention rates were not significantly different between the monotherapy and cotherapy groups, regardless of the type of anti-TNF treatment. The overall median drug retention was 2.8 years. Significant predictors of drug retention after controlling for confounding variables included male sex, longer disease duration, older age, prior anti-TNF use, steroid use, and baseline scores on the Health Assessment Questionnaire and Bath Ankylosing Spondylitis Disease Activity Index.
In addition, there was no significant effect of DMARDs on anti-TNF retention relating to the type of anti-TNF therapy, clinical manifestations of disease (peripheral vs. axial), or diagnosis (axial spondyloarthritis vs. psoriatic arthritis), Dr. Nissen said.
The study was sponsored by unrestricted research grants from Abbott and Pfizer.
CHICAGO – Adding disease-modifying antirheumatic drugs to anti-TNF therapy failed to enhance drug retention in a study involving 1,630 adults with spondyloarthritis.
Current ankylosing spondylitis recommendations from the Assessment of SpondyloArthritis international Society (ASAS) and the European League Against Rheumatism do not support adding disease-modifying antirheumatic drugs (DMARDs) to anti-TNF therapy, said Dr. Michael Nissen of University Hospital Geneva (Switzerland).
Yet, in practice, cotherapy often is prescribed, and the impact of this addition has not been well studied, he said at the annual meeting of the American College of Rheumatology.
"Utilization of a DMARD with an anti-TNF agent is of no additional benefit in SpA [spondyloarthritis] patients in terms of drug survival," and the study findings support the current treatment recommendations, he added.
Dr. Nissen and his colleagues reviewed data from patient registries that included 1,060 adults with axial spondyloarthritis, 535 with psoriatic arthritis, and 35 with undifferentiated spondyloarthritis.
A total of 1,123 patients (69%) had anti-TNF monotherapy and 507 (31%) had DMARD/anti-TNF cotherapy. Among the cotherapy patients, 72% received methotrexate, 21% received sulfasalazine, and 14% received leflunomide. The mean ages in the monotherapy and cotherapy groups were 43 years and 46 years, respectively, and slightly more than half of patients in each group were male.
After a median follow-up period of 4 years, overall drug retention rates were not significantly different between the monotherapy and cotherapy groups, regardless of the type of anti-TNF treatment. The overall median drug retention was 2.8 years. Significant predictors of drug retention after controlling for confounding variables included male sex, longer disease duration, older age, prior anti-TNF use, steroid use, and baseline scores on the Health Assessment Questionnaire and Bath Ankylosing Spondylitis Disease Activity Index.
In addition, there was no significant effect of DMARDs on anti-TNF retention relating to the type of anti-TNF therapy, clinical manifestations of disease (peripheral vs. axial), or diagnosis (axial spondyloarthritis vs. psoriatic arthritis), Dr. Nissen said.
The study was sponsored by unrestricted research grants from Abbott and Pfizer.
CHICAGO – Adding disease-modifying antirheumatic drugs to anti-TNF therapy failed to enhance drug retention in a study involving 1,630 adults with spondyloarthritis.
Current ankylosing spondylitis recommendations from the Assessment of SpondyloArthritis international Society (ASAS) and the European League Against Rheumatism do not support adding disease-modifying antirheumatic drugs (DMARDs) to anti-TNF therapy, said Dr. Michael Nissen of University Hospital Geneva (Switzerland).
Yet, in practice, cotherapy often is prescribed, and the impact of this addition has not been well studied, he said at the annual meeting of the American College of Rheumatology.
"Utilization of a DMARD with an anti-TNF agent is of no additional benefit in SpA [spondyloarthritis] patients in terms of drug survival," and the study findings support the current treatment recommendations, he added.
Dr. Nissen and his colleagues reviewed data from patient registries that included 1,060 adults with axial spondyloarthritis, 535 with psoriatic arthritis, and 35 with undifferentiated spondyloarthritis.
A total of 1,123 patients (69%) had anti-TNF monotherapy and 507 (31%) had DMARD/anti-TNF cotherapy. Among the cotherapy patients, 72% received methotrexate, 21% received sulfasalazine, and 14% received leflunomide. The mean ages in the monotherapy and cotherapy groups were 43 years and 46 years, respectively, and slightly more than half of patients in each group were male.
After a median follow-up period of 4 years, overall drug retention rates were not significantly different between the monotherapy and cotherapy groups, regardless of the type of anti-TNF treatment. The overall median drug retention was 2.8 years. Significant predictors of drug retention after controlling for confounding variables included male sex, longer disease duration, older age, prior anti-TNF use, steroid use, and baseline scores on the Health Assessment Questionnaire and Bath Ankylosing Spondylitis Disease Activity Index.
In addition, there was no significant effect of DMARDs on anti-TNF retention relating to the type of anti-TNF therapy, clinical manifestations of disease (peripheral vs. axial), or diagnosis (axial spondyloarthritis vs. psoriatic arthritis), Dr. Nissen said.
The study was sponsored by unrestricted research grants from Abbott and Pfizer.
FROM THE ANNUAL MEETING OF THE AMERICAN COLLEGE OF RHEUMATOLOGY
Major Finding: After a median follow-up period of 4 years, overall drug retention rates were not significantly different between the monotherapy and cotherapy groups, regardless of the type of anti-TNF treatment. Overall median drug retention was 2.8 years.
Data Source: A patient group of 1,060 adults with axial spondyloarthritis, 535 with psoriatic arthritis, and 35 with undifferentiated spondyloarthritis.
Disclosures: The study was sponsored by unrestricted research grants from Abbott and Pfizer.