Treatment overview of axial spondyloarthritis in 2023

Baraliakos, X.; Kiltz, U.; Kononenko, I.; Ciurea, A.

doi:10.1016/j.berh.2023.101858

Cited by 7 publications

(3 citation statements)

References 109 publications

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“…The management of axSpA comprises pharmacological and non-pharmacological treatment options. Recently, the ASAS-European League Against Rheumatism (EULAR) recommendations for the management of axSpA has been updated [89]. Besides non-pharmacological treatments such as physiotherapy and physical activity, the first line treatment option are still non-steroidal anti-inflammatory drugs (NSAIDs) followed by biologic disease-modifying antirheumatic drugs (bDMARDs) like tumor necrosis factor inhibitors (TNFi) and interleukin-17 inhibitors (IL-17i) and targeted synthetic (ts)-disease-modifying antirheumatic drugs (DMARDs; JAK-inhibitors) [90].…”

Section: Similarities and Differences In Disease Management And Thera...mentioning

confidence: 99%

Diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis—similarities and differences

Kiefer,

Khan,

Baraliakos

2023

Explor Musculoskeletal Dis

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Diffuse idiopathic skeletal hyperostosis (DISH) and axial spondyloarthritis (axSpA) are diseases with inflammatory involvement of the axial skeleton that can result in new bone formation that may lead to total ankylosis of the spine and functional impairment of different extent in individual patients. In these diseases, the new bone formation may lead to total ankylosis of the spine and impaired mobility with functional impairment. This review will highlight the similarities and differences of these two conditions. In axSpA, the genetic background with the association with human leukocyte antigen-B27 (HLA-B27) is known for 50 years, while in DISH, a genetic contribution is not yet proven. The phenotype of new bone formation and its anatomic features are different between these diseases. In axSpA symmetric, thin and marginal syndesmophytes representing an ossification of enthesitic inflammation at the area of the attachment of the annulus fibrosus that may extend to the adjacent deeper layers anterior longitudinal ligament and are typical, while in DISH the so-called “chunky bridging osteophytes” grow as an additional layer on the anterior longitudinal ligament. Besides distinct anamnestic and clinical features, magnetic resonance imaging is helpful differentiating the two diseases since inflammatory changes with the typical pattern of axSpA are reliably visualized. Similar in both diseases is the high prevalence of vertebral fractures, which are mainly caused by the local osteoporosis and decreased flexibility of the affected bones, and therefore may occur even after minor traumata. The presence of extraarticular manifestations like uveitis, inflammatory bowel disease or psoriasis are only linked to axSpA. In contrast, DISH is associated with obesity, diabetes mellitus, and other metabolic diseases. Although DISH and axSpA are distinct conditions, the cooccurrence of these two diseases exists in some patients. Various therapeutic options are becoming available for axSpA, but no therapy has been approved for DISH yet.

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Section: Similarities and Differences In Disease Management And Thera...mentioning

confidence: 99%

Diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis—similarities and differences

Kiefer,

Khan,

Baraliakos

2023

Explor Musculoskeletal Dis

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“…Immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS), are chronic, progressive, and disabling conditions that cause joint pain and, if untreated, can result in structural damage with associated loss of function [ 1 – 5 ]. Management of these diseases has been improved over the past decades with employment of early aggressive treatment strategies and the availability of effective treatment options [ 6 – 8 ]. Tumor necrosis factor inhibitor (TNFi) biologics (e.g., adalimumab [ADA], infliximab, etanercept, golimumab, certolizumab) can improve disease activity and other clinical outcomes, particularly for patients who do not tolerate or respond adequately to conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Management of these diseases has been improved over the past decades with employment of early aggressive treatment strategies and the availability of effective treatment options [ 6 – 8 ]. Tumor necrosis factor inhibitor (TNFi) biologics (e.g., adalimumab [ADA], infliximab, etanercept, golimumab, certolizumab) can improve disease activity and other clinical outcomes, particularly for patients who do not tolerate or respond adequately to conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment Persistence and Switching Patterns of Adalimumab Biosimilar ABP 501 in European Patients with Rheumatologic Diseases

Jin,

Kruppert,

Scholz

et al. 2024

Rheumatol Ther

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Introduction ABP 501 was an adalimumab (ADA) biosimilar approved for treating immune-mediated inflammatory diseases (IMIDs) including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). In this retrospective study, we aimed to examine the treatment patterns of ABP 501 among patients with these IMIDs using German and French pharmacy claims databases. Methods Patients with RA, PsA, or AS who initiated ABP 501 between October 2018 and March 2020 and were observed continuously for ≥ 365 days both before and after ABP 501 initiation were included. Descriptive analyses of persistence and switch after ABP 501 discontinuation were conducted and reported for each disease cohort by prior use of ADA products (patients naïve to ADA or patients experienced with ADA). Results Median (95% confidence interval) persistence on ABP 501 was 9.4 (8.6–10.3), 10.2 (9.0–11.7), and 12.1 (11.0–13.1) months in German patients, and 11.7 (9.9–13.3), 7.1 (5.8–8.4), and 10.8 (9.6–11.9) months in French patients for RA, PsA, and AS, respectively. For patients who switched from ABP 501 to another targeted therapy during the first 12 months of follow-up, switching patterns varied between patients naïve to ADA and patients experienced with ADA in both Germany and France, with patients naïve to ADA switching most frequently to other targeted therapies including non-ADA tumor necrosis factor inhibitor (TNFi), non-TNFi biologic, or Janus Kinase inhibitor (JAKi) and patients experienced with ADA switching most frequently back to ADA reference product (RP). Conclusions Across three rheumatologic diseases, about half of patients persisted on ABP 501 at the end of 12 months after treatment initiation in both Germany and France. Patients experienced with ADA were more likely to switch back to ADA RP, regardless of indication and country, suggesting a possible nocebo effect. Future studies are warranted to understand reasons of discontinuation and switching. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-024-00647-4.

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Analysis of the shorter drug survival times for Janus kinase inhibitors and interleukin-17 inhibitors compared with tumor necrosis factor inhibitors in a real-world cohort of axial spondyloarthritis patients - a retrospective analysis from the RHADAR network

Strunz,

Englbrecht,

Risser

et al. 2024

Rheumatol Int

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In recent years Janus kinase inhibitors (JAKi) have joined tumor necrosis factor inhibitors (TNFi) and interleukin (IL)-17 inhibitors (IL-17i) as approved disease modifying anti-rheumatic drugs (DMARD) for moderate to severe forms of axial spondyloarthritis (axSpA). Drug survival in axSpA patients has not been well studied in a real-world outpatient scenario since the approval of JAKi. We aimed to analyze the three drug classes based on modes of actions (MoA) for their persistence rates among German axSpA outpatients. A retrospective analysis of the RHADAR database for axSpA patients with a new initiation of TNFi, IL-17i, or JAKi treatment between January 2015 and October 2023 was conducted. Analyses included Kaplan-Meier curves and adjusted Cox regressions for drug discontinuation. 1222 new biological DMARD (TNFi [n = 954], IL-17i [n = 190]) or JAKi (n = 78) treatments were reported. The median drug survival was 31 months for TNFi, 25 for IL-17i, and 18 for JAKi. The corresponding 2-year drug survival rate was 79.6%, 72.6%, and 62.8% for TNFi, IL-17i, and JAKi, respectively. The probability for discontinuation for JAKi was significantly higher compared with TNFi (HR 1.91 [95% CI 1.22–2.99]) as well as for IL-17i compared with TNFi (HR 1.43 [95% CI 1.02–2.01]), possibly related to more frequent use of TNFis as first-line therapy. IL-17i and JAKi discontinuation probabilities were similar. Primary non-response was the reason for drug discontinuation in most cases across all MoA. TNFi treatment might persist longer than JAKi and IL-17i in German axSpA outpatients, possibly related to more severe or refractory disease in patients with JAKi-treated or IL-17i-treated axSpA.

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Treatment overview of axial spondyloarthritis in 2023

Cited by 7 publications

References 109 publications

Diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis—similarities and differences

Diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis—similarities and differences

Treatment Persistence and Switching Patterns of Adalimumab Biosimilar ABP 501 in European Patients with Rheumatologic Diseases

Analysis of the shorter drug survival times for Janus kinase inhibitors and interleukin-17 inhibitors compared with tumor necrosis factor inhibitors in a real-world cohort of axial spondyloarthritis patients - a retrospective analysis from the RHADAR network

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