One-Third of European Patients With Axial Spondyloarthritis Reach Pain Remission With Routine Care Tumor Necrosis Factor Inhibitor Treatment

Ørnbjerg, Lykke Midtbøll; Rugbjerg, Kathrine; Georgiadis, Stylianos; Rasmussen, Simon; Lindström, Ulf; Pavelka, Karel; Yılmaz, Neslihan; Favalli, Ennio Giulio; Nissén, Michael John; Michelsen, Brigitte; Sousa, E.; Jones, Gareth T; Ionescu, Ruxandra; Relas, Heikki; Sánchez‐Piedra, Carlos; Tomšič, Matija; Geirsson, Árni Jón; Horst-Bruinsma, Irene E van der; Askling, Johan; Loft, Anne Gitte; Nekvindová, Lucie; Direskeneli, Haner; Iannone, Florenzo; Ciurea, Adrian; Fagerli, K.; Santos, María José; Macfarlane, Gary J.; Codreanu, Cătălin; Eklund, Kari K.; Pombo‐Suárez, Manuel; Rotar, Žiga; Guðbjörnsson, Björn; Rusman, Tamara; Østergaard, Mikkel; Hetland, Merete Lund

doi:10.3899/jrheum.220459

Cited by 7 publications

(5 citation statements)

References 40 publications

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“…More than half of our sample consisted of women who may have a weaker response to treatment, low drug adherence, and a high disease activity score 57 . Also, anti‐tumor necrosis factor (anti‐TNF) has been proposed to stabilize the disease status and improve physical function, while of all 114 patients, only 27 of them were having anti‐TNF treatment in our study 58,59 . Another explanation for the high disease activity of our patients may be related to the number of individuals using the anti‐TNF treatment and not having any treatment.…”

Section: Discussionmentioning

confidence: 95%

“…57 Also, anti-tumor necrosis factor (anti-TNF) has been proposed to stabilize the disease status and improve physical function, while of all 114 patients, only 27 of them were having anti-TNF treatment in our study. 58,59 Another explanation for the high disease activity of our patients may be related to the number of individuals using the anti-TNF treatment and not having any treatment. Since no differences were detected for treatment methods among frailty status for both frailty classification tools, we cannot speculate about the effectiveness of the treatment choices on reversing pre-frailty or frailty status.…”

Section: Discussionmentioning

confidence: 99%

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Identifying frailty and its associated factors in patients with axial spondyloarthritis

2023

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Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease which predominantly affects the axial skeleton with or without radiographic damage. 1 Radiographic axSpA affects men more than women, while non-radiographic axSpA has an equal gender distribution and its peak incidence is approximately at age 30. 2,3 Axial SpA is characterized by functional impairment, pain, reduced mobility, fatigue, sleep disturbances, and poor quality of life (QoL). 4 Non-radiographic axSpA also causes impairment in physical function and QoL similar to radiographic axSpA. 5,6 A decrease in QoL is associated with poor physical function, 7 increased disease activity, fatigue, pain, 8 anxiety, and depression 9 in axSpA patients.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Identifying frailty and its associated factors in patients with axial spondyloarthritis

2023

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“…Its involvement in AS has been extensively studied. Drugs inhibiting TNF, such as adalimumab, golimumab, infliximab, certolizumab pegol, and etanercept, have shown significant effectiveness in the treatment of AS ( 5 , 28 ). This further establishes the reliability of our study that TNF as a drug target for the treatment of AS.…”

Section: Discussionmentioning

confidence: 99%

Proteome-wide Mendelian randomization identifies therapeutic targets for ankylosing spondylitis

Zhao,

Fang,

Lai

et al. 2024

Front. Immunol.

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BackgroundAnkylosing Spondylitis (AS) is a chronic inflammatory disorder which can lead to considerable pain and disability. Mendelian randomization (MR) has been extensively applied for repurposing licensed drugs and uncovering new therapeutic targets. Our objective is to pinpoint innovative therapeutic protein targets for AS and assess the potential adverse effects of druggable proteins.MethodsWe conducted a comprehensive proteome-wide MR study to assess the causal relationships between plasma proteins and the risk of AS. The plasma proteins were sourced from the UK Biobank Pharma Proteomics Project (UKB-PPP) database, encompassing GWAS data for 2,940 plasma proteins. Additionally, GWAS data for AS were extracted from the R9 version of the Finnish database, including 2,860 patients and 270,964 controls. The colocalization analysis was executed to identify shared causal variants between plasma proteins and AS. Finally, we examined the potential adverse effects of druggable proteins for AS therapy by conducting a phenome-wide association study (PheWAS) utilizing the extensive Finnish database in version R9, encompassing 2,272 phenotypes categorized into 46 groups.ResultsThe findings revealed a positive genetic association between the predicted plasma levels of six proteins and an elevated risk of AS, while two proteins exhibited an inverse association with AS risk (Pfdr < 0.05). Among these eight plasma proteins, colocalization analysis identified AIF1, TNF, FKBPL, AGER, ALDH5A1, and ACOT13 as shared variation with AS(PPH3+PPH4>0.8), suggesting that they represent potential direct targets for AS intervention. Further phenotype-wide association studies have shown some potential side effects of these six targets (Pfdr < 0.05).ConclusionOur investigation examined the causal connections between six plasma proteins and AS, providing a comprehensive understanding of potential therapeutic targets.

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“…A similar observation has been made in axial spondyloarthritis, where patients with extremely high PRO scores had worse response to TNFi than patients with more favorable PRO scores at baseline. 41,42 We hypothesize that these observations are a result of comorbidities such as chronic widespread pain or fibromyalgia, which are known to be frequent in patients with PsA and diminish treatment response. 43,44 It is one of the limitations of our study that no data on comorbidities were available for analyses.…”

Section: Discussionmentioning

confidence: 99%

Patient-Reported Outcomes (PROs) and PRO Remission Rates in 12,262 Biologic-Naïve Patients With Psoriatic Arthritis Treated With Tumor Necrosis Factor Inhibitors in Routine Care

Ørnbjerg,

Rugbjerg,

Georgiadis

et al. 2024

J Rheumatol

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ObjectiveTo evaluate patient-reported outcomes (PROs) after initiation of tumor necrosis factor inhibitor (TNFi) treatment in European real-world patients with psoriatic arthritis (PsA). Further, to investigate PRO remission rates across treatment courses, registries, disease duration, sex and age at disease onset.MethodsVisual-analogue-scale or Numerical Rating Scale scores for pain, fatigue, patient global, and Health Assessment Questionnaire disability index (HAQ) from 12,262 PsA patients initiating a TNFi in 13 registries were pooled. PRO remission rates (pain ≤1, fatigue ≤2, patient global ≤2, HAQ ≤0.5) were calculated for patients still on drug.ResultsFor the 1st TNFi, median pain score was reduced by ≈50% (baseline/6/12/24 months: 6/3/3/2) as were fatigue (6/4/4/3), patient global (6/3/3/2) and HAQ scores (0.9/0.5/0.5/0.4). Six months' LUNDEX-adjusted remission rates for pain/fatigue/patient global/HAQ were 24%/31%/36%/43% (1st TNFi), 14%/19%/23%/29% (2nd TNFi) and (9%/14%/17%/20% (3rd TNFi). For bio-naïve patients with disease duration <5 years, 6-months LUNDEX-adjusted remission rates for pain/fatigue/patient global/HAQ were 22%/28%/33%/42%. Corresponding rates for patients with disease duration >10 years were 27%/32%/41%/43%. Remission rates were 33%/40%/45%/56% for men and 17%/23%/24%/32% for women. For patients <45 years at diagnosis, 6-months LUNDEX-adjusted remission rate for pain was 28% vs. 18% for patients ≥45 years.ConclusionIn 12,262 biologic-naïve PsA patients, 6 months treatment with TNFi reduced pain by approximately 50%. Marked differences in PRO remission rates across treatment courses, registries, disease duration, sex and age at onset of disease were observed, emphasizing the potential influence of other factors than disease activity on PROs.

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One-Third of European Patients With Axial Spondyloarthritis Reach Pain Remission With Routine Care Tumor Necrosis Factor Inhibitor Treatment

Cited by 7 publications

References 40 publications

Identifying frailty and its associated factors in patients with axial spondyloarthritis

Identifying frailty and its associated factors in patients with axial spondyloarthritis

Proteome-wide Mendelian randomization identifies therapeutic targets for ankylosing spondylitis

Patient-Reported Outcomes (PROs) and PRO Remission Rates in 12,262 Biologic-Naïve Patients With Psoriatic Arthritis Treated With Tumor Necrosis Factor Inhibitors in Routine Care

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