RT Journal Article
T1 Switching related to inefficacy in biologics and targeted synthetic therapies for psoriatic arthritis: a comparative real-life study
A1 Freites Nuñez, Dalifer
A1 León, Leticia
A1 Toledano Martínez, María Esther
A1 Candelas Rodríguez, Gloria Del Mar
A1 Martínez, Cristina
A1 Rodríguez Laguna, María
A1 Rubio, Daniel
A1 Fernández Gutiérrez, Benjamín
A1 Abasolo, Lydia
AB Background:Switching between therapies is a recommended strategy for psoriatic arthritis (PsA) patients who experience treatment failure; however, studies including real-life data are scarce.Objectives:To assess the incidence rate (IR) of switching between biologics and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) due to inefficacy in PsA, and to compare the risk of switching due to inefficacy across different b/tsDMARDs groups.Design:A longitudinal retrospective study, spanning from 2007 to 2022, was conducted on patients with PsA treated with b/tsDMARDs at an outpatient rheumatology clinic.Methods:The primary outcome was switching between b/tsDMARDs due to inefficacy. The independent variable was the exposure to b/tsDMARDs during follow-up. As covariates, clinical, treatment-related, and sociodemographic variables were considered. Survival techniques were run to estimate the IR of switching due to inefficacy per 100 patients*year and confidence interval at 95% (95% CI). Cox multivariate regression analyses were run to assess the risk of b/tsDMARDs switching due to inefficacy, expressed as hazard ratio (HR) and 95% CI.Results:In all, 141 patients were included, with 893.09 patients*year follow-ups. 52.48% of them were females in their fifties. In total, 262 courses of treatment were recorded. During the study period, 56 patients presented 121 switches and 103 related to inefficacy (IR: 11.53 (9.51–13.98)). Tumor necrosis factor-alpha inhibitors (TNFi) showed the lowest IR. In the bivariate analysis, all b/tsDMARDs had more risk of switching compared to TNFi (HR: anti-lL-17 vs TNFi: 2.26 (1.17–4.36); others vs TNFi: 3.21 (1.59–6.45)); however, this statistical significance was no longer present in the multivariate analysis once adjustments were made for the covariates. Still, the final model achieved statistical significance in the following variables: gender, clinical symptoms, prescription year, therapy courses, glucocorticoids, and sulfasalazine.Conclusion:In this study, we did not find differences in the rate of switching due to inefficacy among different groups of b/tsDMARDs. Other concomitant treatments, sociodemographic, and clinical variables were identified as risk factors for switching due to inefficacy.
PB SAGE Publications
SN 1759-720X
YR 2024
FD 2024-07-12
LK https://hdl.handle.net/20.500.14352/114260
UL https://hdl.handle.net/20.500.14352/114260
LA eng
NO Freites-Nuñez D, Leon L, Toledano E, et al. Switching related to inefficacy in biologics and targeted synthetic therapies for psoriatic arthritis: a comparative real-life study. Therapeutic Advances in Musculoskeletal Disease. 2024;16. doi:10.1177/1759720X241273083
NO Fondos FEDER
NO European Commission
NO Instituto de Salud Carlos III (España)
NO Red de Enfermedades Inflamatorias (España)
NO Ministerio de Sanidad (España)
DS Docta Complutense
RD 16 abr 2025