Patient-reported outcomes and PRO remission rates in 12,262 biologic-naïve patients with psoriatic arthritis treated with TNF-inhibitors in routine care.

Abstract

OBJECTIVE

To 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.

METHODS

Visual-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.

RESULTS

For 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.

CONCLUSION

In 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.