Early Tumor Necrosis Factor α Antagonist Therapy in Everyday Practice for Inflammatory Back Pain Suggesting Axial Spondyloarthritis: Results From a Prospective Multicenter French Cohort

Canouï‐Poitrine, Florence; Poulain, Cécile; Moltó, Anna; Thuaut, Aurélie Le; Lafon, Cécile; Farrenq, Valérie; Ferkal, Salah; Corvoisier, Philippe Le; Ghaleh, Bijan; Bastuji‐Garin, Sylvie; Fautrel, Bruno; Dougados, Maxime; Claudepierre, Pascal

doi:10.1002/acr.22330

Cited by 10 publications

(4 citation statements)

References 26 publications

(22 reference statements)

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“…One may speculate that NSAIDs would control the axial symptoms in both groups, but the presence of arthritis could increase the likelihood of starting a TNFb because of the higher disease activity and the negative impact of peripheral arthritis on PROs. In fact, a previous study in the DESIR cohort has demonstrated that the Ankylosing Spondylitis Disease Activity Score (ASDAS) and the presence of synovitis act as independent factors associated with TNFb initiation [27].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of concomitant peripheral arthritis in patients with recent onset axial spondyloarthritis: 5-year results from the DESIR cohort

et al. 2019

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Background (a) To describe the prevalence and incidence of peripheral arthritis during 5 years of follow-up in recent axial spondyloarthritis (axSpA), (b) to evaluate factors associated with their appearance and (c) to assess their impact on treatment, patient-reported outcomes and sick leave after follow-up. Methods Data from the early axSpA patients from the DESIR cohort (first 5 years of follow-up) were analysed. Prevalence and incidence of peripheral arthritis at each study visit were calculated. A multivariate analysis was performed to evaluate baseline factors associated with the development of the arthritis. The use of drugs, the impact on patient-reported outcomes and days of sick leave were compared in both groups over time. Results Out of the 708 patients included in DESIR, 255 (36.0%) showed at least one episode of arthritis (151 before the inclusion visit and 104 during the follow-up), with an incidence of 3.7 cases per 100 person-years. Patients with peripheral arthritis were more likely (OR, 95%CI) to be aged ≥ 33 years (1.60, 1.12–2.27), non-smokers (1.58, 1.10–2.27) and HLAB27 negative (1.47, 1.04–2.08) and have presented with at least one episode of dactylitis (8.50, 4.96–14.60) and enthesitis (2.00, 1.41–2.84). Patients with peripheral arthritis showed a significant greater use of TNFb, csDMARDs and corticosteroids over follow-up; higher levels on BASDAI (40.46 vs. 34.28) and BASFI (27.89 vs. 22.52); poorer quality of life; and higher number of days of sick leave (17.97 vs. 12.78) over time. Conclusion In recent axSpA, 36% of patients reported peripheral arthritis at any time of the disease, being associated with negative HLAB27, non-smokers and with other peripheral manifestations. Patients with arthritis showed a higher burden of disease.

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Section: Discussionmentioning

confidence: 99%

Evaluation of concomitant peripheral arthritis in patients with recent onset axial spondyloarthritis: 5-year results from the DESIR cohort

et al. 2019

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“…Data from the Swiss Clinical Quality Management Cohort showed that nearly two‐thirds of patients who fulfilled the ASAS classification criteria for axial SpA, regardless of radiographic status, initiated TNF inhibitor therapy after inclusion, suggesting that the indications for TNF inhibitor treatment were similar in patients with and those without radiographic involvement . Among 708 patients with early inflammatory back pain suggestive of axial SpA in the French DESIR cohort, 23.4% and 30.2% of patients received a TNF inhibitor within 12 and 24 months of follow‐up, respectively .…”

Section: Discussionmentioning

confidence: 99%

Characterization of Patients With Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis in the US‐Based Corrona Registry

Mease

Heijde

Karki³

et al. 2018

Arthritis Care & Research

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ObjectiveTo describe the characteristics of patients with ankylosing spondylitis (AS) and patients with nonradiographic axial spondyloarthritis (SpA) in the US.MethodsDemographics, clinical characteristics, patient‐reported outcomes, and treatment characteristics of patients with AS and those with nonradiographic axial SpA were assessed at the time of enrollment in the Corrona Psoriatic Arthritis/Spondyloarthritis Registry. Patients with AS were defined as those who fulfilled the 1984 modified New York criteria for AS; patients with nonradiographic axial SpA were defined as all other patients with axial SpA who did not fulfill the radiology criterion.ResultsOf the 407 patients with a diagnosis of axial SpA who were included in this study, 310 had AS, and 97 had nonradiographic axial SpA. Although patients with nonradiographic axial SpA were younger and showed a trend toward a shorter symptom duration, the nonradiographic axial SpA and AS groups shared a similar disease burden, as reflected by comparisons of disease activity and function, quality of life, pain, fatigue, job absenteeism, and loss of work productivity (all P > 0.05). The proportions of patients with nonradiographic axial SpA and patients with AS who received prior biologic disease‐modifying drugs (DMARDs) (74.2% and 64.8%, respectively) or were currently receiving biologic DMARDs (63.9% and 61.3%, respectively) were also similar (P > 0.05).ConclusionThis was the first nationwide study to characterize patients with AS and nonradiographic axial SpA in the US. Consistent with studies published outside of the US, this study showed that patients with nonradiographic axial SpA and patients with AS shared a comparable degree of disease burden and had similar treatment patterns in clinical practice.

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“…For Western and Japanese patients, TNF inhibition therapy is highly effective for alleviating the signs and symptoms of AS and non-radiographic axial SpA [ 6 – 8 , 14 – 17 ]. With adalimumab therapy for non-radiographic SpA patients from America, Europe, and Australia, the mean BASDAI change was −1.9 at the primary endpoint at 12 weeks [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of Japanese patients with axial spondyloarthritis, and short-term efficacy of adalimumab

Otsuka

Morita

Yamada

2015

Journal of Orthopaedic Science

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BackgroundAnkylosing spondylitis (AS) is rarer in Japan than in Europe, probably because the European criteria, not well known by Japanese general physicians, regard AS as a progressive stage of axial spondyloarthritis (SpA). HLA-B27 is an important diagnostic marker of SpA; however, the incidence of the HLA-B27 allele is as low as 0.4 % in Japan. For Japanese SpA patients, other HLA alleles and clinical findings are required for earlier definitive diagnosis, for determining appropriate treatment timing, and for disease monitoring.MethodsWe investigated the HLA-B alleles of 36 patients clinically diagnosed with SpA. For 8 axial SpA patients we evaluated the short-term efficacy of subcutaneous adalimumab injections (40 mg every other week for ≥11 months). Treatment efficacy was evaluated by use of the Bath Ankylosing Spondylitis Activity Index (BASDAI) score, and serum TNF-α and IL-6 levels were measured pre and post-treatment.ResultsAmong the 36 Japanese SpA patients, the HLA-B27 allele occurred infrequently (5.6 %) whereas the HLA-B44 and 61 alleles were the most frequently detected (25.0 %). We also detected severe bamboo spine on radiography in the absence of the HLA-B27 allele. All 8 patients with axial SpA experienced significant symptom improvement after adalimumab treatment; the HLA-B27 allele was absent from these patients. Serum TNF-α and IL-6 levels were elevated in cases with remarkable inflammatory pain and high disease activity. These cytokines decreased after therapy, however. Most patients with normal cytokine levels at baseline retained these low levels.ConclusionsThe findings reveal the short-term efficacy of adalimumab. The remarkably low incidence of HLA-B27 among our patients indicates that HLA-B distribution is different from that in other countries. Serum TNF-α and IL-6 levels were not effective as biomarkers for cases without high disease activity, and further research with larger samples is needed. The efficacy of TNF blockers, however, suggested a potential localized TNF effect was present among SpA patients.

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Early Tumor Necrosis Factor α Antagonist Therapy in Everyday Practice for Inflammatory Back Pain Suggesting Axial Spondyloarthritis: Results From a Prospective Multicenter French Cohort

Cited by 10 publications

References 26 publications

Evaluation of concomitant peripheral arthritis in patients with recent onset axial spondyloarthritis: 5-year results from the DESIR cohort

Evaluation of concomitant peripheral arthritis in patients with recent onset axial spondyloarthritis: 5-year results from the DESIR cohort

Characterization of Patients With Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis in the US‐Based Corrona Registry

Clinical characteristics of Japanese patients with axial spondyloarthritis, and short-term efficacy of adalimumab

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